FDA Adverse Event Other Summary report: N

DELTACUT

MDR report key: 1063708 · Received June 19, 2008

Report

Report Number
9611612-2008-00008
Event Type
Other
Date Received
June 19, 2008
Date of Event
May 28, 2008
Report Date
June 18, 2008
Manufacturer
PAJUNK GMBH MEDIZINTECHNOLOGIE
Product Code
KNW
PMA / PMN Number
K063233
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

EVENT TOOK PLACE IN OTHER COUNTRY. NO SPECIFIC CORRECTIVE ACTION DUE TO MITIGATIVE PREVENTION OF HAZARDS IS ASSIGNED TO THIS REPORT. A REVIEW OF THE CURRENT DEVICE HISTORY RECORD AND THE RAW MATERIAL HISTORY FILES AS WELL AS POST MARKET SURVEILLANCE SHOWED NO RECORDED QUALITY PROBLEMS OR REJECTIONS RELATED TO THIS DEVICE. BASED UPON INVESTIGATIONAL EFFORTS AND UPON THE END USERS NARRATIVE, THE INCIDENT IS EVALUATED TO BE A USER ERROR. THIS FILE IS CONSIDERED AS CLOSED.

Description of Event or Problem · 1

EVENT TOOK PLACE IN OTHER COUNTRY. FIRST ATTEMPT TO GAIN SPECIMEN FAILED DUE TO USER ERROR. SECOND ATTEMPT NECESSARY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DELTACUT CANNULA FOR SOFT TISSUE BIOPSY KNW PAJUNK GMBH MEDIZINTECHNOLOGIE NA NA

Patients

Seq Age Sex Outcome Treatment
1 Other