BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    APPLIED MEDICAL

    MDR report key: 1570751 · Received December 24, 2009

    Report

    Report Number
    MW5014162
    Event Type
    Malfunction
    Date Received
    December 24, 2009
    Date of Event
    December 16, 2009
    Report Date
    December 24, 2009
    Manufacturer
    APPLIED
    Product Code
    FBQ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    TROCAR NOT UNLOCKING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 APPLIED MEDICAL 8MM TROCAR COQ19 FBQ APPLIED

    Patients

    Seq Age Sex Outcome Treatment
    1 31 YR