BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BLACKMAX SYSTEM NOSEPIECE ATTACHMENTS

    MDR report key: 532671 · Received March 10, 2004

    Report

    Report Number
    1045834-2004-00219
    Event Type
    Malfunction
    Date Received
    March 10, 2004
    Date of Event
    February 12, 2004
    Report Date
    March 10, 2004
    Manufacturer
    THE ANSPACH EFFORT, INC.
    Product Code
    HSZ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    CUSTOMER STATED THERE IS A CUTTER STUCK IN THE ATTACHMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BLACKMAX SYSTEM NOSEPIECE ATTACHMENTS ATTACHMENT HSZ THE ANSPACH EFFORT, INC. B-SILVER 25023

    Patients

    Seq Age Sex Outcome Treatment
    1 *