BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FREER ELEVATOR

    MDR report key: 1582261 · Received January 6, 2010

    Report

    Report Number
    1582261
    Event Type
    Malfunction
    Date Received
    January 6, 2010
    Date of Event
    January 6, 2010
    Report Date
    January 6, 2010
    Manufacturer
    *
    Product Code
    GEG
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    AZ, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THE END OF THE FREER ELEVATOR BROKE OFF. BROKEN TIP WAS RETRIEVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FREER ELEVATOR INSTRUMENT, SURGICAL GEG * N/A N/A

    Patients

    Seq Age Sex Outcome Treatment
    1 24 YR