MAVIG - PORTEGRA 2 OT60U01 *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2007-01-29 for MAVIG - PORTEGRA 2 OT60U01 * manufactured by Mavig Gmbh.

Event Text Entries

[578285] Upon moving the lead shield during a patient procedure, one of the covers fell off of one of the joints and hit the patient in the face, resulting in a scratch to the left eye. (mavig arm-portegra 2)
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number814545
MDR Report Key814545
Date Received2007-01-29
Date of Report2007-01-25
Report Date2007-01-25
Date Reported to FDA2007-01-29
Date Added to Maude2007-02-13
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameMAVIG - PORTEGRA 2
Generic NameX-RAY, SHIELD
Product CodeKPY
Date Received2007-01-29
Model NumberOT60U01
Catalog Number*
Lot Number*
ID Number*
OperatorOTHER
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key802029
ManufacturerMAVIG GMBH
Manufacturer Address25 HYTEC CIRCLE ROCHESTER NY 146064255 US


Patients

Patient NumberTreatmentOutcomeDate
10 2007-01-29

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