CRILE ARTERY FORCEPS (6 1/4") CURVED 105-141

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-02-27 for CRILE ARTERY FORCEPS (6 1/4") CURVED 105-141 manufactured by Integra York Pa, Inc. /jarritt Surgical Instruments.

Event Text Entries

[137560420] Approximately 5mm portion of? Crile artery forceps (6?? ) curved? Clamp tip (1 tip) identified to be missing at the conclusion of the procedure.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5084508
MDR Report Key8378427
Date Received2019-02-27
Date of Report2019-02-26
Date of Event2019-02-25
Date Added to Maude2019-02-28
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 Details

Brand NameCRILE ARTERY FORCEPS (6 1/4") CURVED
Generic NameCRILE CLAMP
Product CodeGEN
Date Received2019-02-27
Model Number105-141
Catalog Number105-141
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerINTEGRA YORK PA, INC. /JARRITT SURGICAL INSTRUMENTS
Manufacturer AddressYORK PA 17402 US 17402


Patients

Patient NumberTreatmentOutcomeDate
10 2019-02-27

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