FDA Adverse Event Malfunction Summary report: N

11G BLADED MAMMOTOME ST PROBE

MDR report key: 681232 · Received February 27, 2006

Report

Report Number
1527736-2006-00825
Event Type
Malfunction
Date Received
February 27, 2006
Report Date
February 2, 2006
Manufacturer
ETHICON ENDO SURGERY, INC.
Product Code
KNW
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INFORMATION IS UNAVAILABLE; DEVICE WAS NOT RETURNED FOR EVALUATION. 510(K)# IS K991980.

Description of Event or Problem · 1

PLASTIC SHAVINGS ALONG WITH THE SPECIMENT WERE IN THE COLLECTION CHAMBER. THE DOCTOR WAS ABLE TO FINISH THE BREAST BIOPSY WITHOUT CONSEQUENCES REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 11G BLADED MAMMOTOME ST PROBE MAMMOTOME PROBES KNW ETHICON ENDO SURGERY, INC. NA NI

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN