UNK

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2006-01-26 for UNK manufactured by Unk.

Event Text Entries

[395035] Pt in o. R. For hysteroscopy, fractional dilation and curettage of uterus. There was small bleeding from a lacerated tenaculum site, which was hemostatic with application of figure of eight sutures, #3-0 vicryl and silver nitrate sticks.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number670428
MDR Report Key670428
Date Received2006-01-26
Date of Report2006-01-25
Date of Event2005-08-18
Date Facility Aware2006-01-25
Report Date2006-01-25
Date Reported to FDA2006-01-25
Date Added to Maude2006-02-03
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameUNK
Generic NameSINGLE-TOOTHED TENACULUM
Product CodeHDC
Date Received2006-01-26
Model NumberUNK
Catalog NumberUNK
Lot NumberUNK
ID NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeUNKNOWN
Implant FlagN
Date RemovedA
Device Sequence No1
Device Event Key659738
ManufacturerUNK
Manufacturer AddressUNK * *


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2006-01-26

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