FERRIS SMITH RONG FORCEPS STR 4X10MM 7IN NL6052

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,consum report with the FDA on 2020-01-23 for FERRIS SMITH RONG FORCEPS STR 4X10MM 7IN NL6052 manufactured by Carefusion, Inc.

MAUDE Entry Details

Report Number1423507-2020-00004
MDR Report Key9622634
Report SourceCOMPANY REPRESENTATIVE,CONSUM
Date Received2020-01-23
Date of Report2020-01-23
Date of Event2019-11-13
Date Mfgr Received2020-01-14
Date Added to Maude2020-01-23
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 ContactBDX ANNA WEHRHEIM
Manufacturer Street75 NORTH FAIRWAY DRIVE
Manufacturer CityVERNON HILLS IL 60061
Manufacturer CountryUS
Manufacturer Postal60061
Manufacturer Phone8015652341
Manufacturer G1CAREFUSION, INC
Manufacturer Street75 NORTH FAIRWAY DRIVE
Manufacturer CityVERNON HILLS IL 60061
Manufacturer CountryUS
Manufacturer Postal Code60061
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameFERRIS SMITH RONG FORCEPS STR 4X10MM 7IN
Generic NameRONGEUR, MANUAL
Product CodeHAE
Date Received2020-01-23
Catalog NumberNL6052
OperatorHEALTH PROFESSIONAL
Device Availability*
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerCAREFUSION, INC
Manufacturer Address75 NORTH FAIRWAY DRIVE VERNON HILLS IL 60061 US 60061


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2020-01-23

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