BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    V. MUELLER

    MDR report key: 81122 · Received April 2, 1997

    Report

    Report Number
    MW1010811
    Event Type
    Malfunction
    Date Received
    April 2, 1997
    Date of Event
    February 19, 1997
    Report Date
    March 10, 1997
    Manufacturer
    V-MUELLER BAXTER HEALTHCARE
    Product Code
    GEG
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CO, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    AT THE COMPLETION OF THE CASE, SURGEON NOTICED THAT A SMALL PIECE OF THE ELEVATOR FREER WAS MISSING. IT IS UNKNOWN WHETHER IT WAS RETAINED IN THE PT OR LOST ELSEWHERE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 V. MUELLER ELEVATOR FREER GEG V-MUELLER BAXTER HEALTHCARE RH-750 *

    Patients

    Seq Age Sex Outcome Treatment
    1 53 YR Other