BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    LAPAROSCOPIC 5MM BABCOCK

    MDR report key: 1970133 · Received January 21, 2011

    Report

    Report Number
    MW5019103
    Event Type
    Malfunction
    Date Received
    January 21, 2011
    Date of Event
    January 3, 2011
    Report Date
    January 7, 2011
    Manufacturer
    BRUDER HEALTHCARE COMPANY
    Product Code
    GCJ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    WHILE MD WAS USING THE BABCOCK, IT BROKE WHILE INSIDE THE PT. NO HARM WAS DONE. (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LAPAROSCOPIC 5MM BABCOCK NONE GCJ BRUDER HEALTHCARE COMPANY

    Patients

    Seq Age Sex Outcome Treatment
    1 0 DA