BEUDAMED
    FDA Adverse Event Injury Summary report: N

    OFFSET DOUBLE CLAMP BAR

    MDR report key: 629254 · Received August 23, 2005

    Report

    Report Number
    1035617-2005-00005
    Event Type
    Injury
    Date Received
    August 23, 2005
    Date of Event
    March 10, 2005
    Report Date
    July 20, 2005
    Manufacturer
    ZIMMER ORTHOPAEDIC SURGICAL PRODUCTS
    Product Code
    HSQ
    Report Source
    Manufacturer report
    Reporter Location
    CT, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PATIENT'S TRACTION COLLAPSED ALLEGEDLY CAUSING BLUNT TRAUMA TO BACK OF PATIENT HEAD. PATIENT FOUND MOANING AND WITH A LARGE AMOUNT OF BLOOD. DOCTOR PLACED STAPLES IN PATIENT'S HEAD WHICH RESOLVED BLEEDING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 OFFSET DOUBLE CLAMP BAR TRACTION ACCESSORY HSQ ZIMMER ORTHOPAEDIC SURGICAL PRODUCTS * NI

    Patients

    Seq Age Sex Outcome Treatment
    1 *