BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SW-BLADE HOOK NEW

    MDR report key: 531647 · Received March 4, 2004

    Report

    Report Number
    1038548-2004-00010
    Event Type
    Malfunction
    Date Received
    March 4, 2004
    Date of Event
    February 24, 2004
    Report Date
    March 4, 2004
    Manufacturer
    SNOWDEN PENCER, INC.
    Product Code
    LRW
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE SCISSOR TIP FELL OFF INTO THE PT, THE PRODUCT WAS RETREIVED AND THERE WAS NO INJURY TO THE PT. FACILITY STATES THAT THE INSULATION SEEMS TO BE IN THE WAY OF CONNECTING THE SCISSOR CORRECTLY TO THE HANDLE. FACILITY ASKS THAT ALL CORRESPONDENCE REFERENCE THEIR COMPLAINT NUMBER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SW-BLADE HOOK NEW * LRW SNOWDEN PENCER, INC. 89-5200B 778374

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN