#10 PRE-MADE PACK *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2006-07-28 for #10 PRE-MADE PACK * manufactured by Bd Vendor.

Event Text Entries

[19150711] #10 knife blade broke while dr. Was using it. Pieces recovered and placed in specimen cup labeled with pt info. Risk mgmt has the specimen.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number742952
MDR Report Key742952
Date Received2006-07-28
Date of Report2006-07-10
Date of Event2006-05-22
Date Facility Aware2006-05-22
Report Date2006-07-10
Date Added to Maude2006-08-03
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 Name#10 PRE-MADE PACK
Generic NameKNIFE
Product CodeEMF
Date Received2006-07-28
Model Number#10 PRE-MADE PACK
Catalog Number*
Lot Number*
ID Number*
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Age*
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key730760
ManufacturerBD VENDOR
Manufacturer AddressONE BECTON DR. FRANKLINE LAKE NJ * US


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2006-07-28

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