BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MEDLINE KONIG MOGEN CIRCUMCISION CLAMPS

    MDR report key: 19499173 · Received June 7, 2024

    Report

    Report Number
    MW5155995
    Event Type
    Injury
    Date Received
    June 7, 2024
    Date of Event
    May 18, 2024
    Report Date
    June 5, 2024
    Manufacturer
    MEDLINE INDUSTRIES, LP - NORTHFIELD
    Product Code
    HFX
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    WV, US
    Reporter Occupation
    RISK MANAGER
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    WHEN MOGEN PULLED BACK TO ADJUST PLACEMENT, THERE APPEARED TO BE A LACERATION ON THE LEFT SIDE OF THE NEWBORNS PENIS DURING CIRCUMCISION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    184243 MEDLINE KONIG MOGEN CIRCUMCISION CLAMPS CLAMP, CIRCUMCISION HFX MEDLINE INDUSTRIES, LP - NORTHFIELD

    Patients

    Seq Age Sex Outcome Treatment
    1 0 DA Male Required Intervention