BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CODMAN

    MDR report key: 302247 · Received October 13, 2000

    Report

    Report Number
    302247
    Event Type
    Injury
    Date Received
    October 13, 2000
    Date of Event
    July 12, 2000
    Report Date
    July 28, 2000
    Manufacturer
    CODMAN JOHNSON & JOHNSON MEDICAL LTD
    Product Code
    GAJ
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    MA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    WHILE PERFORMING VEIN STRIPPING PROCEDURE, VEIN STRIPPER DEVICE BROKE WHILE STILL IN PT'S LEG. X-RAYS WERE TAKEN TO LOCATE DEVICE IN PT. TWO ADD'L INCISIONS WERE REQUIRED TO RETRIEVE THE DEVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CODMAN DISPOSABLE VEIN STRIPPER GAJ CODMAN JOHNSON & JOHNSON MEDICAL LTD * KR 417

    Patients

    Seq Age Sex Outcome Treatment
    1 55 YR Required Intervention