MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-08-02 for RIGID SIDEKICK 890-304 manufactured by Boston Scientific Corporation.
[81602532]
Patient Sequence No: 1, Text Type: N, H10
[81602533]
The needle bent inside the urethra.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 6759756 |
| MDR Report Key | 6759756 |
| Date Received | 2017-08-02 |
| Date of Report | 2017-07-18 |
| Date of Event | 2017-07-03 |
| Report Date | 2017-07-18 |
| Date Reported to FDA | 2017-07-18 |
| Date Reported to Mfgr | 2017-07-18 |
| Date Added to Maude | 2017-08-02 |
| Event Key | 0 |
| Report Source Code | User Facility report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | RIGID SIDEKICK |
| Generic Name | ENDOSCOPIC INJECTION NEEDLE, GASTROENTEROLOGY |
| Product Code | FBK |
| Date Received | 2017-08-02 |
| Model Number | 890-304 |
| Catalog Number | 890-304 |
| Lot Number | 100098672 |
| Device Availability | Y |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BOSTON SCIENTIFIC CORPORATION |
| Manufacturer Address | 100 BOSTON SCIENTIFIC WAY MARLBOROUGH MA 01752 US 01752 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2017-08-02 |