MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-03-18 for ADISON CRANIAL RONGEUR 53-1040 manufactured by Codman & Shurtleff, Inc..
[183935552]
While using a rongeur out of an amputation set, the tip broke off in the right great toe during the procedure. X-rays taken. Not retained. No harm to patient.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9847492 |
| MDR Report Key | 9847492 |
| Date Received | 2020-03-18 |
| Date of Report | 2020-03-16 |
| Date of Event | 2020-03-11 |
| Report Date | 2020-03-16 |
| Date Reported to FDA | 2020-03-16 |
| Date Reported to Mfgr | 2020-03-18 |
| Date Added to Maude | 2020-03-18 |
| 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 | 3 |
| Reporter Occupation | RISK MANAGER |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ADISON CRANIAL RONGEUR |
| Generic Name | RONGEUR, MANUAL |
| Product Code | HAE |
| Date Received | 2020-03-18 |
| Model Number | 53-1040 |
| Catalog Number | 53-1040 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | CODMAN & SHURTLEFF, INC. |
| Manufacturer Address | 325 PARAMOUNT DRIVE RAYNHAM MA 02767 US 02767 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-03-18 |