FDA Adverse Event Summary report: N

HEATH HEAVYWEIGHT MALLET

MDR report key: 2599885 · Received June 4, 2012

Report

Report Number
2599885
Date Received
June 4, 2012
Date of Event
May 31, 2012
Report Date
June 4, 2012
Manufacturer
SSI, A DIVISION OF SYMMETRY MEDICAL
Product Code
GFJ
Report Source
User Facility report
Reporter Location
FL, US
Reporter Occupation
RISK MANAGER

Narratives

Description of Event or Problem · 1

AS SURGEON WAS USING MALLET, THE HEAD OF THE MALLET CAME OFF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEATH HEAVYWEIGHT MALLET HEAVY MALLET GFJ SSI, A DIVISION OF SYMMETRY MEDICAL * *

Patients

Seq Age Sex Outcome Treatment
1 67 YR