FDA Adverse Event Other Summary report: N

MST BARRETT V2 I/A TIP

MDR report key: 2162288 · Received July 9, 2011

Report

Report Number
3019924-2011-00013
Event Type
Other
Date Received
July 9, 2011
Date of Event
June 9, 2011
Report Date
July 7, 2011
Manufacturer
MICROSURGICAL TECHNOLOGY INC
Product Code
HQE
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE OPERATED AS DESIGNED. THE DEVICE EVALUATION REVEALED GOUGING AND SCRATCHES BUT THESE SIGNS OF USE ARE NOT THOUGHT TO HAVE CONTRIBUTED TO THE EVENT.

Description of Event or Problem · 1

THE DOCTOR REPORTED THAT A 1.5MM PUNCTURE OF THE CAPSULE CAUSED A CHANGE OF PROCEDURE.

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