BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MICRO BULLDOG APPLYING FORCEP

    MDR report key: 1935408 · Received November 16, 2010

    Report

    Report Number
    1044475-2010-00147
    Event Type
    Malfunction
    Date Received
    November 16, 2010
    Date of Event
    November 1, 2010
    Report Date
    November 1, 2010
    Manufacturer
    TELEFLEX MEDICAL
    Product Code
    DXC
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    THE SAMPLE DEVICE HAS NOT BEEN REC'D, THEREFORE THE INVESTIGATION IS INCOMPLETE AT TIME OF THIS REPORT. A F/U INVESTIGATION REPORT WILL BE SENT WHEN COMPLETED.

    Description of Event or Problem · 1

    THE EVENT IS REPORTED AS: THE HEAD OF THE DEVICE IS SMALLER THAN THE OLDER DEVICES. THIS DEVICE WON'T HOLD CLIPS PROPERLY. NO PT INJURY REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MICRO BULLDOG APPLYING FORCEP BULLDOG FORCEP DXC TELEFLEX MEDICAL NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1