BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CENTURION CLAMP

    MDR report key: 17351433 · Received July 17, 2023

    Report

    Report Number
    MW5119590
    Event Type
    Malfunction
    Date Received
    July 17, 2023
    Date of Event
    July 1, 2023
    Report Date
    July 13, 2023
    Manufacturer
    CENTURION MEDICAL PRODUCTS, LP
    Product Code
    HFX
    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

    CLAMP POPPING OFF AND WOULD NOT RETAIN TISSUE AS INTENDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    840336 CENTURION CLAMP CLAMP HFX CENTURION MEDICAL PRODUCTS, LP CIT5935A 23ABQ353

    Patients

    Seq Age Sex Outcome Treatment
    1 1 DA Male