FDA Adverse Event Malfunction Summary report: N

BUDDE HALO RETRACTOR

MDR report key: 3994699 · Received June 11, 2014

Report

Report Number
3004608878-2014-00090
Event Type
Malfunction
Date Received
June 11, 2014
Report Date
May 15, 2014
Manufacturer
INTEGRA LIFESCIENCES CORPORATION OH/USA
Product Code
GZT
PMA / PMN Number
K830332
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TO DATE, THE DEVICE INVOLVED IN THE REPORTED INCIDENT HAS NOT BEEN RECEIVED FOR EVAL. AN INVESTIGATION HAS BEEN INITIATED BASED UPON THE REPORTED INFO.

Description of Event or Problem · 1

A 438A 1011 COMPONENT OF THE A1040 BUDDE HALO WAS REPORTED TO HAVE A HOLE AT THE RAIL SLIDING PORTION OF THE UNIT. THE EVENT WAS FOUND UPON INSPECTION; THEREFORE, THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
344702 BUDDE HALO RETRACTOR RETRACTOR SYSTEMS GZT INTEGRA LIFESCIENCES CORPORATION OH/USA 139

Patients

Seq Age Sex Outcome Treatment
1