BEUDAMED
    FDA Adverse Event Injury Summary report: N

    JOHNSON & JOHNSON (CODMAN)

    MDR report key: 488882 · Received October 1, 2003

    Report

    Report Number
    488882
    Event Type
    Injury
    Date Received
    October 1, 2003
    Date of Event
    August 27, 2003
    Report Date
    September 3, 2003
    Manufacturer
    JOHNSON & JOHNSON HEALTHCARE
    Product Code
    GAJ
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    NY, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    DIAGNOSIS: VARICOSE VEIN. PROCEDURE: SAPHENOUS STRIPPING. INCIDENT: WHEN REMOVING DEEP VEIN STRIPPER FROM PT'S LEG, NOTICED SMALL BULLET TIP WAS MISSING. ULTRASOUND SHOWED NO FINDINGS, FOUND ON X-RAY, LOCATED BEHIND KNEE. REQUIRED INCISION ON BACK OF KNEE FOR REMOVAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 JOHNSON & JOHNSON (CODMAN) DEEP VEIN STRIPPER GAJ JOHNSON & JOHNSON HEALTHCARE * FV495

    Patients

    Seq Age Sex Outcome Treatment
    1 41 YR Required Intervention