FDA Adverse Event Malfunction Summary report: N

CRYOSOLUTIONS SET WITH 1 CARTRIDGE/1MM TIP

MDR report key: 2512682 · Received March 28, 2012

Report

Report Number
2523190-2012-00030
Event Type
Malfunction
Date Received
March 28, 2012
Report Date
March 28, 2012
Manufacturer
INTEGRA YORK, PA INC.
Product Code
GEH
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TO DATE, THE DEVICE INVOLVED IN THE REPORTED INCIDENT HAS NOT BEEN RECEIVED FOR EVAL. AN INVESTIGATION HAS BEEN INITIATED BASED ON THE REPORTED INFO.

Description of Event or Problem · 1

DR. WAS CHANGING CARTRIDGE ON UNIT. WHEN HE INSERTED THE NEW CARTRIDGE, THE GAS SHOT OUT AND BURNED HIS HAND IN THE THUMB AND FOREFINGER AREA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CRYOSOLUTIONS SET WITH 1 CARTRIDGE/1MM TIP M3-DERMAL GEH INTEGRA YORK, PA INC.

Patients

Seq Age Sex Outcome Treatment
1