FDA Adverse Event
Other
Summary report: N
HOMER MAMMOLOK
MDR report key: 13278
·
Received May 17, 1994
Report
- Report Number
- MW1002000
- Event Type
- Other
- Date Received
- May 17, 1994
- Date of Event
- October 28, 1992
- Report Date
- May 6, 1994
- Manufacturer
- NORTH AMERICAN INSTRUMENT CORP.
- Product Code
- MIJ
- Report Source
- Voluntary report
- Reporter Location
- LA, US
- Reporter Occupation
- PHYSICIAN
Narratives
Description of Event or Problem · 1
THIS CASE WAS A NEEDLE LOCALIZED BREAST BIOPSY. THE NEEDLE HAD A HARPOON TIP AND UPON EXTRACTION OF THE SPECIMEN, THE HOOK OF THE HARPOON BROKE OFF AND LODGED IN PT'S BREAST TISSUE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | HOMER MAMMOLOK | HARPOON NEEDLE LOCALIZED WIRE | MIJ | NORTH AMERICAN INSTRUMENT CORP. | UNKNOWN | UNKNOWN |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 56 YR | Other |