BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ENDO DISSECT 5MM INSTRUMENT

    MDR report key: 1991227 · Received January 28, 2011

    Report

    Report Number
    2647580-2011-00071
    Event Type
    Malfunction
    Date Received
    January 28, 2011
    Report Date
    December 22, 2010
    Manufacturer
    USSC PUERTO RICO
    Product Code
    GET
    PMA / PMN Number
    K904578
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AS
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4).

    Description of Event or Problem · 1

    ACCORDING TO THE REPORTER: THE JAWS WERE BROKEN. NO ADDITIONAL INFO AVAILABLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ENDO DISSECT 5MM INSTRUMENT DISPOSABLE SURGICAL DEVICE GET USSC PUERTO RICO P9L0078

    Patients

    Seq Age Sex Outcome Treatment
    1