FDA Adverse Event Malfunction Summary report: N

GRASPER, ALLIGATOR 2.7MM UPCURVED

MDR report key: 1651699 · Received April 2, 2010

Report

Report Number
1219602-2010-00069
Event Type
Malfunction
Date Received
April 2, 2010
Date of Event
March 2, 2010
Report Date
March 2, 2010
Manufacturer
MANSFIELD MANUFACTURING SITE
Product Code
NBH
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT BEEN RETURNED BY THE CUSTOMER FOR EVALUATION. (B) (4)

Description of Event or Problem · 1

DURING THE SURGERY, THE DOCTOR WENT TO BITE A LOOSE BODY AND THE JAW BROKE OFF. IT TOOK TWO HOURS TO RETRIEVE THE PIECE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GRASPER, ALLIGATOR 2.7MM UPCURVED GRASPER, ALLIGATOR 2.7MM UPCURVED / NBH NBH MANSFIELD MANUFACTURING SITE 011021 50052769

Patients

Seq Age Sex Outcome Treatment
1