MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2005-08-17 for GRASPING BIOPSY FORCEPS 8383.471 manufactured by Richard Wolf Medical Instruments.
[18489132]
Biopsy forceps tooth came off in pt. Dr was not able to ascertain the tooth. Was removed after suctioning attempts. No x-ray was done according to initial reporter. No other complications or adverse effects was reported.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 743168 |
| MDR Report Key | 743168 |
| Date Received | 2005-08-17 |
| Date of Report | 2005-08-11 |
| Date of Event | 2005-07-15 |
| Date Facility Aware | 2005-07-15 |
| Report Date | 2005-08-11 |
| Date Reported to Mfgr | 2005-07-22 |
| Date Added to Maude | 2006-08-03 |
| 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 |
| Reporter Occupation | RISK MANAGER |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | GRASPING BIOPSY FORCEPS |
| Generic Name | GRASPING BIOPSY FORCEPS |
| Product Code | DWZ |
| Date Received | 2005-08-17 |
| Model Number | 8383.471 |
| Catalog Number | 8383.471 |
| Lot Number | UNK |
| ID Number | NA |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | UNKNOWN |
| Implant Flag | N |
| Date Removed | * |
| Device Sequence No | 1 |
| Device Event Key | 730965 |
| Manufacturer | RICHARD WOLF MEDICAL INSTRUMENTS |
| Manufacturer Address | * VERNON HILLS IL 60061 US |
| Baseline Brand Name | GRASPING BIOPSY FORCEPS |
| Baseline Generic Name | GRASPING BIOPSY FORCEPS |
| Baseline Model No | 8383.471 |
| Baseline Catalog No | 8383.471 |
| Baseline ID | NA |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2005-08-17 |