FDA Adverse Event Injury Summary report: N

CODMAN DISPOSABLE VEIN STRIPPER

MDR report key: 369174 · Received January 2, 2002

Report

Report Number
1226348-2002-00003
Event Type
Injury
Date Received
January 2, 2002
Report Date
December 5, 2001
Manufacturer
CODMAN & SHURTLEFF, INC.
Product Code
GAJ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
RISK MANAGER

Narratives

Description of Event or Problem · 1

AFFILIATE IN FRANCE REPORTS THE DISTAL PORTION OF THE VEIN STRIPPER BROKE AND STAYED TOGETHER WITH THE OLIVE IN THE PATIENT'S VEIN. THE PROCEDURE WAS DEPLYAED WHILE THE SURGEON MADE ANOTHER INCISION IN ORDER TO REMOVE THE BROKEN PORTION OF THE DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CODMAN DISPOSABLE VEIN STRIPPER STRIPPER, VEIN, DISPOSABLE GAJ CODMAN & SHURTLEFF, INC. NA CT648

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Required Intervention