BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    5600040-6500JQD REUSE J HOOK

    MDR report key: 378857 · Received February 21, 2002

    Report

    Report Number
    1213643-2002-00012
    Event Type
    Malfunction
    Date Received
    February 21, 2002
    Date of Event
    January 24, 2002
    Report Date
    February 21, 2002
    Manufacturer
    DAVOL, INC. (RI)
    Product Code
    HFG
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OR, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    TIP BROKE OFF BELOW INSULATION - 2 EACH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 5600040-6500JQD REUSE J HOOK 350401210-ES ELECTRODES HFG DAVOL, INC. (RI) * UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 *