MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional report with the FDA on 2019-03-29 for TC METZENBAUM SCISSORS DEL CVD 200MM BC275R manufactured by Aesculap Ag.
[140310840]
(b)(4). When additional information is received a follow up report will be submitted.
Patient Sequence No: 1, Text Type: N, H10
[140310841]
It was reported by the healthcare professional "that the wrong item number is on the scissors. " the product is mislabeled. All med watch submissions related to this are: 9610612-2019-00204; 9610612-2019-00205.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9610612-2019-00203 |
| MDR Report Key | 8464011 |
| Report Source | FOREIGN,HEALTH PROFESSIONAL |
| Date Received | 2019-03-29 |
| Date of Report | 2019-03-28 |
| Date Facility Aware | 2019-03-21 |
| Date Mfgr Received | 2019-03-11 |
| Device Manufacturer Date | 2016-04-01 |
| Date Added to Maude | 2019-03-29 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| 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 |
| Manufacturer Contact | MRS. NICOLE BROYLES |
| Manufacturer Street | 615 LAMBERT POINTE DRIVE |
| Manufacturer City | HAZELWOOD MO 63042 |
| Manufacturer Country | US |
| Manufacturer Postal | 63042 |
| Manufacturer G1 | AESCULAP AG |
| Manufacturer Street | PO BOX 40 |
| Manufacturer City | TUTTLINGEN, 78501 |
| Manufacturer Country | GM |
| Manufacturer Postal Code | 78501 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | TC METZENBAUM SCISSORS DEL CVD 200MM |
| Generic Name | DUROTIP SCISSORS |
| Product Code | LRW |
| Date Received | 2019-03-29 |
| Returned To Mfg | 2019-03-12 |
| Model Number | BC275R |
| Catalog Number | BC275R |
| Lot Number | 4507560233 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | AESCULAP AG |
| Manufacturer Address | PO BOX 40 TUTTLINGEN, 78501 GM 78501 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-03-29 |