BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MEGATIP

    MDR report key: 435357 · Received December 26, 2002

    Report

    Report Number
    1721194-2002-00001
    Event Type
    Malfunction
    Date Received
    December 26, 2002
    Date of Event
    October 30, 2002
    Report Date
    December 17, 2002
    Manufacturer
    MEGADYNE MEDICAL PRODUCTS, INC.
    Product Code
    GEI
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    GREEN PART OF L-HOOK CAME OFF IN PATIENT'S ABDOMINAL CAVITY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEGATIP ELECTROSURGICAL ACCESSORY GEI MEGADYNE MEDICAL PRODUCTS, INC. 0600 20856

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Other