BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CODMAN DISPOSABLE VEIN STRIPPER

    MDR report key: 439057 · Received January 22, 2003

    Report

    Report Number
    1226348-2003-00018
    Event Type
    Malfunction
    Date Received
    January 22, 2003
    Date of Event
    December 20, 2002
    Report Date
    December 23, 2002
    Manufacturer
    CODMAN & SHURTLEFF, INC.
    Product Code
    GAJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    TINY PLASTIC CAP ON END OF VEIN STRIPPER BROKE OFF IN VEIN DURING STRIPPING PROCEDURE. PORTION WAS RETRIEVED AND PT IS DOING FINE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CODMAN DISPOSABLE VEIN STRIPPER STRIPPER, VEIN, DISPOSABLE GAJ CODMAN & SHURTLEFF, INC. NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 43 YR Other