BEUDAMED
    FDA Adverse Event Other Summary report: N

    RET, TEBBETTS R/O 90MM X 24MM

    MDR report key: 520380 · Received April 12, 2004

    Report

    Report Number
    1038548-2004-00011
    Event Type
    Other
    Date Received
    April 12, 2004
    Date of Event
    March 29, 2004
    Report Date
    April 7, 2004
    Manufacturer
    SNOWDEN PENCER, INC.
    Product Code
    GAD
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NO
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    THREE PTS HAVE RECEIVED 2ND DEGREE BURNS DUE TO THE LOOSENING OF THE ADAPTER FROM THE RETRACTOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RET, TEBBETTS R/O 90MM X 24MM * GAD SNOWDEN PENCER, INC. 88-1087 392355

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN