FDA Adverse Event Malfunction Summary report: N

SPROTTE

MDR report key: 11989380 · Received June 14, 2021

Report

Report Number
9611612-2021-00007
Event Type
Malfunction
Date Received
June 14, 2021
Date of Event
May 13, 2021
Report Date
October 7, 2021
Product Code
BSP
UDI-DI
04048223103876
PMA / PMN Number
K911202
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
RISK MANAGER

Narratives

Additional Manufacturer Narrative · 0

BASED ON RISK ASSESSMENT AND CLINICAL ASSESSMENT THIS FILE IS CONSIDERED AS CLOSED.

Description of Event or Problem · 0

IRN# (B)(4). "THE INTRODUCERS ARE BENDING AND BREAKING."

Additional Manufacturer Narrative · 1

INFORMATION CURRENTLY QUITE POOR. FOLLOW UP WILL BE SENT IN TO THE AGENCY ONCE MORE INFORMATION IS AVAILABLE.

Description of Event or Problem · 1

IRN#: (B)(4). "THE INTRODUCERS ARE BENDING AND BREAKING."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
892274 SPROTTE SPINAL NEEDLE, SINGLE USE BSP 021151-30A UNKNOWN 04048223103876

Patients

Seq Age Sex Outcome Treatment
1 Other