BEUDAMED
    FDA Adverse Event Injury Summary report: N

    JOKER PERIOSTAL ELEVATOR

    MDR report key: 28900 · Received December 7, 1995

    Report

    Report Number
    28900
    Event Type
    Injury
    Date Received
    December 7, 1995
    Date of Event
    November 16, 1995
    Report Date
    December 7, 1995
    Manufacturer
    UNKNOWN
    Product Code
    GEG
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    OH, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    DURING SURGERY, THE TIP OF THE ELEVATOR BROKE OFF. X-RAY REVEALED TIP IN THE OPEN WOUND. TIP WAS REMOVED PRIOR TO CLOSURE. NO ADVERSE OUTCOME DUE TO THIS EVENT WERE OBSERVED BY THE PT'S PHYSICIAN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 JOKER PERIOSTAL ELEVATOR ELEVATOR GEG UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 35 YR Hospitalization