VIDEOARTHROSCOPE HD 4MM X 30 DEG 72202961S

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-04-16 for VIDEOARTHROSCOPE HD 4MM X 30 DEG 72202961S manufactured by Smith & Nephew, Inc..

Event Text Entries

[142206867] .
Patient Sequence No: 1, Text Type: N, H10


[142206868] It was reported that during a surgery the device was foggy. No patient injuries or delay reported. Back-up device was not available.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3003604053-2019-00048
MDR Report Key8519551
Date Received2019-04-16
Date of Report2019-04-17
Date of Event2019-03-21
Date Mfgr Received2019-04-16
Date Added to Maude2019-04-16
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactJIM GONZALES
Manufacturer Street7000 W WILLIAM CANNON DRIVE
Manufacturer CityAUSTIN TX 78735
Manufacturer CountryUS
Manufacturer Postal78735
Manufacturer Phone5123585706
Manufacturer G1SMITH & NEPHEW, INC.
Manufacturer Street150 MINUTEMAN ROAD
Manufacturer CityANDOVER MA 01810
Manufacturer CountryUS
Manufacturer Postal Code01810
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameVIDEOARTHROSCOPE HD 4MM X 30 DEG
Generic NameNASOPHARYNGOSCOPE (FLEXIBLE OR RIGID)
Product CodeEOB
Date Received2019-04-16
Returned To Mfg2019-04-01
Catalog Number72202961S
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSMITH & NEPHEW, INC.
Manufacturer Address150 MINUTEMAN ROAD ANDOVER MA 01810 US 01810


Patients

Patient NumberTreatmentOutcomeDate
10 2019-04-16

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