FDA Adverse Event Malfunction Summary report: N

DEBAKEY MULTI-PURPOSE CLAMP

MDR report key: 435263 · Received December 24, 2002

Report

Report Number
2515651-2002-00018
Event Type
Malfunction
Date Received
December 24, 2002
Manufacturer
QSA SURGICAL LTD.
Product Code
GDJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE DISTRIBUTOR REPORTED THAT HANDLE OF A DEBAKEY MULTI-PURPOSE CLAMP BROKE DURING USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DEBAKEY MULTI-PURPOSE CLAMP NO. 1 60 DEGREE ANGLED CLAMP, ATRAUGRIP JAW GDJ QSA SURGICAL LTD. * FF5

Patients

Seq Age Sex Outcome Treatment
1 *