BEUDAMED
    FDA Adverse Event Injury Summary report: N

    COOK INCORPORATED

    MDR report key: 1636099 · Received March 16, 2010

    Report

    Report Number
    MW5015187
    Event Type
    Injury
    Date Received
    March 16, 2010
    Date of Event
    January 15, 2010
    Report Date
    March 10, 2010
    Manufacturer
    COOK INC.
    Product Code
    DYB
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    WIRE TIP SHAVED OFF IN PUNCTURE NEEDLE UPON REMOVAL OF WIRE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 COOK INCORPORATED MICROPUNCTURE INTRO SET SILHOUETTE DYB COOK INC. G48007 2422934

    Patients

    Seq Age Sex Outcome Treatment
    1 84 YR