BEUDAMED
    FDA Adverse Event Injury Summary report: N

    V. MUELLER

    MDR report key: 5057990 · Received August 31, 2015

    Report

    Report Number
    MW5055958
    Event Type
    Injury
    Date Received
    August 31, 2015
    Date of Event
    August 19, 2015
    Report Date
    August 31, 2015
    Manufacturer
    CAREFUSION
    Product Code
    OCV
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    FL, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    A MICRO DISSECTOR TIP BROKE OFF IN SIDE THE SURGICAL SITE. DOCTOR WAS ABLE TO LOCATE AND REMOVE THE BROKEN TIP. THE TIP AND THE INSTRUMENT WERE IMMEDIATELY REMOVED FROM THE STERILE FIELD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    575982 V. MUELLER V. MUELLER OCV CAREFUSION NL 3785-010 AIO
    575983 RHOTON HOOK 90 BLUNT RHOTON HOOK 90 BLUNT GZX INTEGRA

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR Required Intervention