BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FALOPE RING BAND

    MDR report key: 17452 · Received November 7, 1994

    Report

    Report Number
    MW1003923
    Event Type
    Malfunction
    Date Received
    November 7, 1994
    Date of Event
    September 19, 1994
    Report Date
    October 13, 1994
    Manufacturer
    CABOT MEDICAL PRODUCTS
    Product Code
    HFY
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    WHILE DOING FALLOPIAN TUBAL BANDING RING BROKE INSIDE ABDOMINAL CAVITY. (ALSO SEE 1003924.)

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FALOPE RING BAND FALLOPIAN TUBE BAND HFY CABOT MEDICAL PRODUCTS 1311001

    Patients

    Seq Age Sex Outcome Treatment
    1 21 YR