BEUDAMED
    FDA Adverse Event Other Summary report: N

    MST BARRETT V2 I/A TIP

    MDR report key: 2141100 · Received June 16, 2011

    Report

    Report Number
    3019924-2011-00008
    Event Type
    Other
    Date Received
    June 16, 2011
    Date of Event
    May 17, 2011
    Report Date
    June 16, 2011
    Manufacturer
    MICROSURGICAL TECHNOLOGY INC
    Product Code
    HQE
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    THE DOCTOR REPORTED THAT DURING THE POLISHING OF THE CAPSULE THERE WERE SMALL STRIA AND A HOLE CREATED IN THE CAPSULE AND AN ANTERIOR VITRECTOMY HAD TO BE PERFORMED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MST BARRETT V2 I/A TIP IRRIGATION/ASPIRATION CANNULA HQE MICROSURGICAL TECHNOLOGY INC BRT-1008 UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 Other