BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FALOPE RING BAND

    MDR report key: 17823 · Received November 17, 1994

    Report

    Report Number
    MW1004055
    Event Type
    Malfunction
    Date Received
    November 17, 1994
    Date of Event
    November 10, 1994
    Report Date
    November 10, 1994
    Manufacturer
    CABOT MEDICAL CORP.
    Product Code
    HFY
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MI, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    DR LOADING FALOPE-RING AND IT SPLIT. STERILIZATION DATE 11/93.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FALOPE RING BAND BAND, TUBAL OCCLUSION HFY CABOT MEDICAL CORP. 1311001

    Patients

    Seq Age Sex Outcome Treatment
    1 27 YR Other