BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CONVERTORS TIBURON

    MDR report key: 835693 · Received March 6, 2007

    Report

    Report Number
    835693
    Event Type
    Malfunction
    Date Received
    March 6, 2007
    Date of Event
    February 28, 2007
    Report Date
    March 6, 2007
    Manufacturer
    CARDINAL HEALTH MEDICAL PRODUCTS AND SERVICES
    Product Code
    KKX
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    GA, US

    Narratives

    Description of Event or Problem · 1

    THE GLUED SEAM OF THE DRAPE SEPARATED AS THE SCRUB PERSON WAS TRYING TO PLACE THE DRAPE. A STAPLE WAS USED TO HOLD IT IN PLACE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CONVERTORS TIBURON DRAPE, SURGICAL KKX CARDINAL HEALTH MEDICAL PRODUCTS AND SERVICES * *

    Patients

    Seq Age Sex Outcome Treatment
    1 *