BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SNOWDEN-PENCER

    MDR report key: 1609760 · Received February 10, 2010

    Report

    Report Number
    1609760
    Event Type
    Malfunction
    Date Received
    February 10, 2010
    Date of Event
    February 8, 2010
    Report Date
    February 10, 2010
    Manufacturer
    CAREFUSION 2200, INC.
    Product Code
    GCJ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    AR, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    TINE BROKE OFF GRASPER. PIECE WAS RETRIEVED BY PHYSICIAN. NO PATIENT INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SNOWDEN-PENCER LAPAROSCOPIC GRASPER GCJ CAREFUSION 2200, INC. * B02R1

    Patients

    Seq Age Sex Outcome Treatment
    1 66 YR