MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2007-09-20 for TRIAD LUBRICATING JELLY * manufactured by Triad Group.
[19054569]
Sterile lubricating jelly used in or. Staff was squeezing it out, and a dead mosquito came with it.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 930497 |
| MDR Report Key | 930497 |
| Date Received | 2007-09-20 |
| Date of Report | 2007-09-20 |
| Date of Event | 2007-02-07 |
| Report Date | 2007-09-20 |
| Date Reported to FDA | 2007-09-20 |
| Date Added to Maude | 2007-10-23 |
| Event Key | 0 |
| Report Source Code | User Facility report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Reporter Occupation | RISK MANAGER |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | TRIAD LUBRICATING JELLY |
| Generic Name | LUBRICATING JELLY |
| Product Code | KMJ |
| Date Received | 2007-09-20 |
| Model Number | * |
| Catalog Number | * |
| Lot Number | 6J02EXP09 08 |
| ID Number | * |
| Operator | NURSE |
| Device Availability | Y |
| Implant Flag | N |
| Date Removed | * |
| Device Sequence No | 1 |
| Device Event Key | 902650 |
| Manufacturer | TRIAD GROUP |
| Manufacturer Address | 19355 JANACEK COURT BROOKFIELD WI 53045 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2007-09-20 |