BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    D-L CROCODILE GRASPER RH 5/32

    MDR report key: 490115 · Received October 15, 2003

    Report

    Report Number
    1038548-2003-00004
    Event Type
    Malfunction
    Date Received
    October 15, 2003
    Date of Event
    September 12, 2003
    Report Date
    October 15, 2003
    Manufacturer
    SNOWDEN PENCER, INC.
    Product Code
    EOQ
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    INSTRUMENT BROKE INSIDE PATIENT - X-RAY WAS TAKEN - PATIENT WAS OPENED TO REMOVE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 D-L CROCODILE GRASPER RH 5/32 * EOQ SNOWDEN PENCER, INC. 90-3022 5217GA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN