FDA Adverse Event Other Summary report: N

MST I/A TIP

MDR report key: 3075017 · Received April 16, 2013

Report

Report Number
3019924-2013-00015
Event Type
Other
Date Received
April 16, 2013
Report Date
April 16, 2013
Manufacturer
MICROSURGICAL TECHNOLOGY, INC.
Product Code
HMX
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PART NUMBER AND LOT NUMBER OF THE DEVICES INVOLVED WERE NOT KNOWN AT THE TIME OF THIS REPORT. THE DEVICES WERE TESTED BY THE DISTRIBUTOR AT NELSON LABORATORIES AND WERE FOUND TO BE NEGATIVE FOR BACTERIAL ENDOTOXINS. THE PTS WERE REPORTED TO BE DOING WELL.

Description of Event or Problem · 1

THE DISTRIBUTOR REPORTED THAT THEIR CUSTOMER HAD AN INCREASE IN POST OPERATIVE INFLAMMATION, THOUGHT TO BE TASS ASSOCIATED WITH MST I/A TIPS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
163099 MST I/A TIP IRRIGATION AND ASPIRATION CANNULA HMX MICROSURGICAL TECHNOLOGY, INC. UNK UNK

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention