BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EURO-MED

    MDR report key: 476155 · Received August 5, 2003

    Report

    Report Number
    1216677-2003-00010
    Event Type
    Injury
    Date Received
    August 5, 2003
    Date of Event
    July 23, 2003
    Report Date
    August 5, 2003
    Manufacturer
    COOPERSURGICAL, INC.
    Product Code
    EME
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NH, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    DURING A PROCEDURE, THE LOWER JAW BROKE OFF. THE BROKEN PIECE WAS REMOVED MANUALLY (FINGERS OR FORCEPS). THERE WAS NO PT INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EURO-MED BIOPSY PUNCH EME COOPERSURGICAL, INC. 64-690 *

    Patients

    Seq Age Sex Outcome Treatment
    1 * Required Intervention