PNEUMO-MATIC INSUFFLATION NEEDLE 900-100

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-12-04 for PNEUMO-MATIC INSUFFLATION NEEDLE 900-100 manufactured by Cooper Surgical.

Event Text Entries

[93849736] Cooper surgical, pneumo-matic insufflation needles, 14 gauge, 150 mm, x would not pass leak test. The 900-210 from lot # 186236 - exp date: 11/2018. The 900-200 from lot # 225665 - exp. Date 07/11/2020.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5073738
MDR Report Key7083362
Date Received2017-12-04
Date of Report2017-12-01
Date of Event2017-12-01
Date Added to Maude2017-12-05
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Sequence Number: 1

Brand NamePNEUMO-MATIC INSUFFLATION NEEDLE
Generic NameVERRES NEEDLE
Product CodeFHO
Date Received2017-12-04
Model Number900-100
Catalog Number900-100
Lot Number225665
Device Expiration Date2010-11-07
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerCOOPER SURGICAL
Manufacturer AddressTRUMBULL CT 06611 US 06611

Device Sequence Number: 2

Brand NamePNEUMO-MATIC INSUFFLATION NEEDLE
Generic NameVERRES NEEDLE
Product CodeFHO
Date Received2017-12-04
Model Number900-210
Catalog Number900-210
Lot Number186236
Device Expiration Date2018-11-30
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No2
Device Event Key0
ManufacturerCOOPER SURGICAL
Manufacturer AddressTRUMBULL CT 06611 US 06611

Device Sequence Number: 3

Brand NamePNEUMO-MATIC INSUFFLATION NEEDLE
Generic NameVERRES NEEDLE
Product CodeFHO
Date Received2017-12-04
Model Number900-210
Catalog Number900-210
Lot Number186236
Device Expiration Date2018-11-30
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No3
Device Event Key0
ManufacturerCOOPER SURGICAL
Manufacturer AddressTRUMBULL CT 06611 US 06611


Patients

Patient NumberTreatmentOutcomeDate
10 2017-12-04

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