BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FOGARTY HUDRAGRIP CLAMP

    MDR report key: 70776 · Received February 20, 1997

    Report

    Report Number
    1423537-1997-00031
    Event Type
    Malfunction
    Date Received
    February 20, 1997
    Report Date
    February 18, 1997
    Manufacturer
    STE - 1923569 - V. MUELLER/SURGICAL GROUP
    Product Code
    DXC
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FR
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THE JAW ON THE CLAMP CRACKED WHILE IN USE ON A SURGICAL PROCEDURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FOGARTY HUDRAGRIP CLAMP VASCULAR CLAMP DXC STE - 1923569 - V. MUELLER/SURGICAL GROUP CV5050 HB

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other