CODMAN DISPOSABLE VEIN STRIPPER 63-4031

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,07 report with the FDA on 2007-06-05 for CODMAN DISPOSABLE VEIN STRIPPER 63-4031 manufactured by Codman & Shurtleff, Inc..

Event Text Entries

[16648118] It has been communicated that the device is not available for evaluation. Without the device it is not possible for codman to conduct a proper investigation. Since a lot number has been provided, a review of the manufacturing records will be reviewed. We anticipate that the evaluation will reveal the device conformed to specifications prior to release. If anything otherwise is found than a follow up report will be filed. If at some point, the device does become available, this complaint will be re-opened, evaluated and a follow up report will be filed. Trends will be monitored for this and similar complaints. At the present time, this complaint is considered closed.
Patient Sequence No: 1, Text Type: N, H10


[16701498] Affiliate reported that the end part of the stripper cable has disconnected twice. The olive has detached from the cable and remained in the patient's leg. As a result surgery was delayed and incision was made to remove the olive.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1226348-2007-00159
MDR Report Key860388
Report Source01,07
Date Received2007-06-05
Date of Event2007-05-03
Date Mfgr Received2007-05-15
Date Added to Maude2007-06-11
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMATTHEW KING
Manufacturer Street325 PARAMOUNT DR.
Manufacturer CityRAYNHAM MA 02767
Manufacturer CountryUS
Manufacturer Postal02767
Manufacturer Phone5088283106
Manufacturer G1CODMAN & SHURTLEFF, INC.
Manufacturer Street325 PARAMOUNT DR.
Manufacturer CityRAYNHAM MA 02767
Manufacturer CountryUS
Manufacturer Postal Code02767
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameCODMAN DISPOSABLE VEIN STRIPPER
Generic NameSTRIPPER, VEIN, DISPOSABLE
Product CodeGAJ
Date Received2007-06-05
Model NumberNA
Catalog Number63-4031
Lot NumberLY630
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Implant FlagN
Date RemovedB
Device Sequence No1
Device Event Key845073
ManufacturerCODMAN & SHURTLEFF, INC.
Manufacturer Address325 PARAMOUNT DR. RAYNHAM MA 02767 US


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2007-06-05

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