BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POREX SURGICAL PRODUCTS

    MDR report key: 408876 · Received July 29, 2002

    Report

    Report Number
    408876
    Event Type
    Malfunction
    Date Received
    July 29, 2002
    Date of Event
    July 12, 2002
    Report Date
    July 29, 2002
    Manufacturer
    POREX SURGICAL INC
    Product Code
    MBS
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NC, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT HAD JONES TUBE INSERTED INTO RIGHT EYE. ATTEMPTED WITH 18MM MEDPORE WRAPPED JONES TUBE; TUBE BROKE, ALL PIECES RECOVERED. ATTEMPTED WITH 20MM MEDPORE WRAPPED JONES TUBE, TUBE BROKE ALL PIECES RECOVERED. 3RD ATTEMPT WITH A SMALLER, PLAIN JONES TUBE SUCCESSFUL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 POREX SURGICAL PRODUCTS MEDPOR SURGICAL IMPLANT MBS POREX SURGICAL INC * 005490502 H

    Patients

    Seq Age Sex Outcome Treatment
    1 56 YR Other