BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DAVOL INC.

    MDR report key: 213142 · Received March 4, 1999

    Report

    Report Number
    MW1015849
    Event Type
    Malfunction
    Date Received
    March 4, 1999
    Manufacturer
    DAVOL, INC., SUB. C.R. BARD, INC.
    Product Code
    JZF
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    VT, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    FRAZIER SUCTION TIP, 3FR AND 5FR DISCONNECTED WHILE SURGEON WAS SUCTIONING PT'S EAR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DAVOL INC. FRAZIER SURGICAL SUCTION INSTRUMENT JZF DAVOL, INC., SUB. C.R. BARD, INC. 0031050 *
    2 DAVOL INC. FRAZIER SURGICAL SUCTION INSTRUMENT JZF DAVOL, INC., SUB. C.R. BARD, INC. 0031030 *

    Patients

    Seq Age Sex Outcome Treatment
    1 *