BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    V. MUELLER HARTMAN CURVED FORCEPS DELICATE

    MDR report key: 6092135 · Received November 10, 2016

    Report

    Report Number
    6092135
    Event Type
    Malfunction
    Date Received
    November 10, 2016
    Date of Event
    October 20, 2016
    Report Date
    November 8, 2016
    Manufacturer
    CAREFUSION 2200, INC.
    Product Code
    GEN
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NV, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    TIP OF MOSQUITO CLAMP BROKE OFF. IT WAS DISCOVERED AFTER THE CASE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    744355 V. MUELLER HARTMAN CURVED FORCEPS DELICATE CLAMP, VASCULAR GEN CAREFUSION 2200, INC. VM25-2385 100312

    Patients

    Seq Age Sex Outcome Treatment
    1 5 YR