FDA Adverse Event Summary report: N

MAYFIELD

MDR report key: 441774 · Received February 3, 2003

Report

Report Number
1525725-2003-00003
Date Received
February 3, 2003
Manufacturer
OHIO MEDICAL INSTRUMENT CO., INC.
Product Code
HBL
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

(OMI) BECAME AWARE OF A POSSIBLE PT INJURY (LACERATION). AT THIS TIME, USER DID NOT HAVE DETAILS OF THE EVENT, BUT DID ACKNOWLEDGE THAT THERE MAY HAVE BEEN AN INCIDENT INVOLVING AN OMI MAYFIELD A2000 SKULL CLAMP. MFR FAXED USER A COPY OF OMI'S "PT EVENT FORM WITH INJURY" WITH A REQUEST TO HAVE THE FORM FILLED OUT WITH INFO PERTAINING TO THE ABOVE EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MAYFIELD SKULL CLAMP HBL OHIO MEDICAL INSTRUMENT CO., INC. 4-0-A-2000 007

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN