DISPOSABLE MICROFORCEPS 2286.KD05

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-01-17 for DISPOSABLE MICROFORCEPS 2286.KD05 manufactured by D. O. R. C. Dutch Ophthalmic Research Center (international) Bv.

Event Text Entries

[176043755] Ilm retinal forcep was faulty, sticking. Fda safety report id: (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5092366
MDR Report Key9610870
Date Received2020-01-17
Date of Report2020-01-15
Date of Event2020-01-13
Date Added to Maude2020-01-21
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameDISPOSABLE MICROFORCEPS
Generic NameFORCEPS, OPHTHALMIC
Product CodeHNR
Date Received2020-01-17
Catalog Number2286.KD05
Lot Number20000393611
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerD. O. R. C. DUTCH OPHTHALMIC RESEARCH CENTER (INTERNATIONAL) BV
Manufacturer AddressNH 03833 US 03833


Patients

Patient NumberTreatmentOutcomeDate
10 2020-01-17

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