BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SURE GRIP TISSUE GRASPER

    MDR report key: 3919014 · Received June 27, 2014

    Report

    Report Number
    1833053-2014-00002
    Event Type
    Malfunction
    Date Received
    June 27, 2014
    Date of Event
    June 10, 2014
    Report Date
    June 26, 2014
    Manufacturer
    G. HIPP AND SOHN
    Product Code
    HXT
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    JA
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    SPIKE OF SURE GRIP SOFT TISSUE GRASPER FELL OFF DURING THE SECOND USE. THE SPIKE WAS SEQUESTERED. NO INJURIES WERE SUSTAINED BY THE PATIENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    376468 SURE GRIP TISSUE GRASPER RONGUER/GRASPER HXT G. HIPP AND SOHN 3645-02 0512GH

    Patients

    Seq Age Sex Outcome Treatment
    1