FDA Adverse Event Other Summary report: N

MICROLINE

MDR report key: 371513 · Received January 11, 2002

Report

Report Number
MW1023814
Event Type
Other
Date Received
January 11, 2002
Manufacturer
MICROLINE
Product Code
GEN
Report Source
Voluntary report
Reporter Location
MA, US
Reporter Occupation
MEDICAL TECHNOLOGIST

Narratives

Description of Event or Problem · 1

"SHRINK WRAP" DISLODGED FROM TIP AND FELL INTO PT'S ABDOMEN DURING USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MICROLINE GRASPER GEN MICROLINE * 10902

Patients

Seq Age Sex Outcome Treatment
1 33 YR Other