BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DISPOSABLE ACTIVE CORD

    MDR report key: 382497 · Received March 11, 2002

    Report

    Report Number
    1519132-2002-00022
    Event Type
    Malfunction
    Date Received
    March 11, 2002
    Date of Event
    February 13, 2002
    Report Date
    March 11, 2002
    Manufacturer
    CIRCON ACMI
    Product Code
    FFZ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    "PRODUCT IS DEFECTIVE." DRS GLOVES WAS BURNT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DISPOSABLE ACTIVE CORD 500 FFZ CIRCON ACMI DAC KE5709

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO