BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CARRIER WIRE FOR KRAUSE NASAL SNARE

    MDR report key: 101842 · Received June 26, 1997

    Report

    Report Number
    101842
    Event Type
    Malfunction
    Date Received
    June 26, 1997
    Date of Event
    May 5, 1997
    Report Date
    June 20, 1997
    Manufacturer
    ALLEGIANCE/MUELLER
    Product Code
    KBE
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    VT, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    CARRIER WIRE FOR KRAUSE NASAL SNARE BROKE DURING SURGERY. DEVICE HAD BEEN ASSEMBLED PROPERLY AND WAS IN THE HANDS OF AN EXPERIENCED SURGEON EXPERIENCED IN USE OF DEVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CARRIER WIRE FOR KRAUSE NASAL SNARE SURGICAL DEVICE - 6 5/8" KBE ALLEGIANCE/MUELLER RH652-170 *

    Patients

    Seq Age Sex Outcome Treatment
    1 12 YR Other