BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CENTURION CLAMP

    MDR report key: 17351408 · Received July 17, 2023

    Report

    Report Number
    MW5119589
    Event Type
    Malfunction
    Date Received
    July 17, 2023
    Date of Event
    June 4, 2023
    Report Date
    July 13, 2023
    Manufacturer
    CENTURION MEDICAL PRODUCTS, LP
    Product Code
    OHG
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OH, US
    Reporter Occupation
    RISK MANAGER
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    CIRCUMCISION CLAMP POPPING OFF, WILL NOT RETAIN TISSUE AS INTENDED/DESIGNED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    840335 CENTURION CLAMP CIRCUMCISION TRAY OHG CENTURION MEDICAL PRODUCTS, LP CIT5935A 23ABQ559

    Patients

    Seq Age Sex Outcome Treatment
    1 1 DA Male