FDA Adverse Event Malfunction Summary report: N

DERMAHOOK 1/2"

MDR report key: 2093506 · Received April 6, 2011

Report

Report Number
3003898360-2011-00133
Event Type
Malfunction
Date Received
April 6, 2011
Date of Event
March 14, 2011
Report Date
March 15, 2011
Manufacturer
TELEFLEX MEDICAL
Product Code
GDG
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

PRODUCT HAS BEEN RECEIVED BY MANUFACTURER. HOWEVER, THE INVESTIGATION REPORT IS INCOMPLETE AT THIS TIME. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: CUSTOMER SAID, SHE RECEIVED PRODUCTS WITH BROKEN BANDS IN THE PACKAGE. NO PATIENT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DERMAHOOK 1/2" DERMAHOOK GDG TELEFLEX MEDICAL NA 01C1000168

Patients

Seq Age Sex Outcome Treatment
1