BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SUCTION COAGULATOR

    MDR report key: 1945179 · Received December 9, 2010

    Report

    Report Number
    1945179
    Event Type
    Malfunction
    Date Received
    December 9, 2010
    Date of Event
    December 8, 2010
    Report Date
    December 9, 2010
    Manufacturer
    A & E MEDICAL
    Product Code
    GEI
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    AZ, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    ON THE WAND OF THE DEVICE THERE IS UNKNOWN DARK GOLD COLORED DUST.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SUCTION COAGULATOR SUCTION COAGULATOR GEI A & E MEDICAL * PACK LOT # 987873

    Patients

    Seq Age Sex Outcome Treatment
    1 *