BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    EVEREST LP SCISSORS

    MDR report key: 1961548 · Received December 29, 2010

    Report

    Report Number
    1961548
    Event Type
    Malfunction
    Date Received
    December 29, 2010
    Date of Event
    December 10, 2010
    Report Date
    December 20, 2010
    Manufacturer
    GYRUS ACMI, INC.
    Product Code
    GEI
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    VA, US

    Narratives

    Description of Event or Problem · 1

    HANDLE OF DEVICE BROKE. REMOVED FROM FIELD. DEVICE WAS A GYRUS ACMI SCISSORS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EVEREST LP SCISSORS BIPOLAR SCISSORS GEI GYRUS ACMI, INC. +H8913804 174295DC

    Patients

    Seq Age Sex Outcome Treatment
    1 * NO OTHER THERAPIES