BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    V. MUELLER

    MDR report key: 3918225 · Received June 30, 2014

    Report

    Report Number
    3918225
    Event Type
    Malfunction
    Date Received
    June 30, 2014
    Date of Event
    June 26, 2014
    Report Date
    June 30, 2014
    Manufacturer
    CAREFUSION 2200, INC
    Product Code
    MDM
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    FL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING SURGERY, THE HEAD OF THE MALLET BROKE FROM HANDLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    378704 V. MUELLER MALLET MDM CAREFUSION 2200, INC * *

    Patients

    Seq Age Sex Outcome Treatment
    1 84 YR NO.