BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SURGITRON

    MDR report key: 446702 · Received March 6, 2003

    Report

    Report Number
    446702
    Event Type
    Malfunction
    Date Received
    March 6, 2003
    Date of Event
    February 23, 2003
    Report Date
    March 5, 2003
    Manufacturer
    ELLMAN INTERNATIONAL, INC.
    Product Code
    GEN
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NY, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    FUNDUS FORCEPS WOULD NOT CLOSE, DURING PROCEDURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SURGITRON DORSEY GRASPING FORCEPS GEN ELLMAN INTERNATIONAL, INC. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 81 YR Other