BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CRILE V. MUELLER

    MDR report key: 7880813 · Received September 17, 2018

    Report

    Report Number
    7880813
    Event Type
    Malfunction
    Date Received
    September 17, 2018
    Date of Event
    August 16, 2018
    Report Date
    September 11, 2018
    Manufacturer
    MCKESSON TECHNOLOGIES, INC.
    Product Code
    GDJ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING SURGERY THE TIP OF THE KELLY CLAMP BROKE OFF 1 INCH. IDENTIFIED IMMEDIATELY. NO FB (FOREIGN BODY) RETAINED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    724055 CRILE V. MUELLER SURGICAL CLAMP GDJ MCKESSON TECHNOLOGIES, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 18615 DA