BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    JARIT

    MDR report key: 3095491 · Received May 1, 2013

    Report

    Report Number
    3095491
    Event Type
    Malfunction
    Date Received
    May 1, 2013
    Date of Event
    April 26, 2013
    Report Date
    May 1, 2013
    Manufacturer
    INTEGRA YORK PA, INC
    Product Code
    HNL
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    RI, US

    Narratives

    Description of Event or Problem · 1

    LACRIMAL DUCT PROBE NUMBER BROKE OFF IN SCRUB'S HAND.DEVICE #1IS THIS A LABORATORY DEVICE OR LABORATORY TEST?NO.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    189985 JARIT LACRIMAL DUCT PROBE HNL INTEGRA YORK PA, INC * *

    Patients

    Seq Age Sex Outcome Treatment
    1 12 YR