BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BLACKMAX SHIELDED ATTACHMENT

    MDR report key: 528745 · Received March 1, 2004

    Report

    Report Number
    1045834-2004-00187
    Event Type
    Malfunction
    Date Received
    March 1, 2004
    Date of Event
    February 3, 2004
    Report Date
    February 24, 2004
    Manufacturer
    THE ANSPACH EFFORT, INC.
    Product Code
    HBB
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    CUSTOMER STATED CUTTER WILL NOT TURN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BLACKMAX SHIELDED ATTACHMENT ATTACHMENT HBB THE ANSPACH EFFORT, INC. B-GREEN *

    Patients

    Seq Age Sex Outcome Treatment
    1 *