BEUDAMED
    FDA Adverse Event Summary report: N

    AMIS BROACH HANDLE

    MDR report key: 3185214 · Received June 12, 2013

    Report

    Report Number
    3006639916-2013-00066
    Date Received
    June 12, 2013
    Date of Event
    May 15, 2013
    Report Date
    June 12, 2013
    Manufacturer
    MEDACTA USA INC.
    Product Code
    LZO
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    SZ
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    THE MOBILE PEG OF THE HANDLE 01.15.10.0131, WAS FOUND TO BE BROKEN. REF MFR NUMBER: 3005180920-2013-00066.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    267004 AMIS BROACH HANDLE REUSABLE SURGICAL INSTRUMENT FOR HIP LZO MEDACTA USA INC. 105840

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK