BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DISPOSABLE ACTIVE CORD

    MDR report key: 121144 · Received August 26, 1997

    Report

    Report Number
    1519132-1997-00051
    Event Type
    Malfunction
    Date Received
    August 26, 1997
    Date of Event
    August 13, 1997
    Manufacturer
    CIRCON ACMI
    Product Code
    FFZ
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    BIOMEDICAL ENGINEER

    Narratives

    Description of Event or Problem · 1

    PT REPORTEDLY SUSTAINED SMALL BURN ON SCROTUM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DISPOSABLE ACTIVE CORD DISPOSABLE ACTIVE CORD FFZ CIRCON ACMI DAC

    Patients

    Seq Age Sex Outcome Treatment
    1