FDA Adverse Event Other Summary report: N

ATEC BREAST BIOPSY AND EXCISION SYSTEM

MDR report key: 2214008 · Received August 1, 2011

Report

Report Number
3003862400-2011-00005
Event Type
Other
Date Received
August 1, 2011
Date of Event
July 1, 2011
Report Date
July 1, 2011
Manufacturer
HOLOGIC, INC.
Product Code
KNW
PMA / PMN Number
K042290
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NH, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

DEVICE WAS EVALUATED BY MFR AND NO TISSUE FILTER WAS PRESENT AT THAT TIME. IT CANNOT BE CONFIRMED WITH CERTAINTY THAT THE TISSUE FILTER WAS NOT PRESENT AT THE TIME IT WAS REC'D BY THE CUSTOMER.

Description of Event or Problem · 1

AN ATEC 1212-20 BIOPSY DEVICE WAS ALLEGEDLY DELIVERED W/O A TISSUE FILTER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ATEC BREAST BIOPSY AND EXCISION SYSTEM KNW - INSTRUMENT, BIOPSY KNW HOLOGIC, INC. ATEC 1212-20 104069

Patients

Seq Age Sex Outcome Treatment
1