BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    KLS BONE REDUCTION CLAMP

    MDR report key: 3896484 · Received June 2, 2014

    Report

    Report Number
    3896484
    Event Type
    Malfunction
    Date Received
    June 2, 2014
    Date of Event
    May 19, 2014
    Report Date
    June 2, 2014
    Manufacturer
    KLS MARTIN LP
    Product Code
    GDJ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US

    Narratives

    Description of Event or Problem · 1

    REDUCTION FORCEP WAS BEING USED BY SURGEON; RIGHT TIP OF FORCEP BROKE OFF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    322522 KLS BONE REDUCTION CLAMP CLAMP GDJ KLS MARTIN LP * *

    Patients

    Seq Age Sex Outcome Treatment
    1 39 YR