BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    V MUELLER

    MDR report key: 1729538 · Received June 10, 2010

    Report

    Report Number
    MW5016408
    Event Type
    Malfunction
    Date Received
    June 10, 2010
    Date of Event
    June 9, 2010
    Report Date
    June 9, 2010
    Manufacturer
    V MUELLER
    Product Code
    GDG
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    WV, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    NERVE HOOK BEING UTILIZED DURING PROCEDURE (ANTERIOR CERVICAL DISSECT FUSION) TIP BROKE OFF IN PATIENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 V MUELLER NONE GDG V MUELLER RHOTON #9 NERVE HOOK FINESHARP

    Patients

    Seq Age Sex Outcome Treatment
    1 56 YR