BEUDAMED
    FDA Adverse Event Other Summary report: N

    BOVIE PENCIL CAUTERY

    MDR report key: 748493 · Received July 1, 2005

    Report

    Report Number
    MW1036039
    Event Type
    Other
    Date Received
    July 1, 2005
    Date of Event
    June 18, 2005
    Report Date
    June 28, 2005
    Manufacturer
    VALLEY LAB - USS VALLEY LAB
    Product Code
    GEI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NJ, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    UPON PRESSING HANDPIECE BUTTON ON BOVIE PENCIL, A FLAME WAS CREATED. PENCIL CAUTERY UNIT - CORD GROUNDING UNIT PAD TAKEN OUT OF SERVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BOVIE PENCIL CAUTERY CAUTERY FORCE 2 GEI VALLEY LAB - USS VALLEY LAB * *

    Patients

    Seq Age Sex Outcome Treatment
    1 88 YR Other