MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-11-08 for MALYUGIN RING MAL-1001-1 manufactured by Microsurgical Technology, Inc..
[126526797]
When surgeon engaged the ring it was found to be bent. The manufacturer provided a returns good authorization number for product return evaluation.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 8050494 |
| MDR Report Key | 8050494 |
| Date Received | 2018-11-08 |
| Date of Report | 2018-11-01 |
| Date of Event | 2018-10-23 |
| Report Date | 2018-11-01 |
| Date Reported to FDA | 2018-11-01 |
| Date Reported to Mfgr | 2018-11-08 |
| Date Added to Maude | 2018-11-08 |
| Event Key | 0 |
| Report Source Code | User Facility report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 0 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| 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 | MALYUGIN RING |
| Generic Name | CLIP, IRIS, RETRACTOR |
| Product Code | HOC |
| Date Received | 2018-11-08 |
| Returned To Mfg | 2018-11-01 |
| Catalog Number | MAL-1001-1 |
| Lot Number | 103124 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | 1 DA |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MICROSURGICAL TECHNOLOGY, INC. |
| Manufacturer Address | 8415 154TH AVENUE NE REDMOND WA 98052 US 98052 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2018-11-08 |