BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MICRO FORCEP WITH ROUND CUP JAW, 2MM

    MDR report key: 534177 · Received March 16, 2004

    Report

    Report Number
    1121308-2004-00004
    Event Type
    Malfunction
    Date Received
    March 16, 2004
    Report Date
    March 16, 2004
    Manufacturer
    INTEGRA LIFESCIENCES CORP.
    Product Code
    HAE
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    USED FOR THE FIRST TIME AND THE FORCEP BROKE. NO PT INJURY WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MICRO FORCEP WITH ROUND CUP JAW, 2MM NON-POWERED SURGICAL INSTRUMENT HAE INTEGRA LIFESCIENCES CORP. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 *