BEUDAMED
    FDA Adverse Event Other Summary report: N

    CANNULA

    MDR report key: 851343 · Received May 3, 2007

    Report

    Report Number
    2027111-2007-00035
    Event Type
    Other
    Date Received
    May 3, 2007
    Date of Event
    April 24, 2007
    Manufacturer
    APPLIED MEDICAL RESOURCES
    Product Code
    HET
    Report Source
    Manufacturer report
    Reporter Location
    LA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    PRODUCT HAS NOT BEEN RETURNED TO THE MANUFACTURER. WHEN RETURNED, PRODUCT WILL BE EVALUATED AND FOLLOW-UP REPORT SENT.

    Description of Event or Problem · 1

    "DR. NOTICED SOMETHING BLACK INSIDE THE PATIENT ON THE SCREEN. REMOVED FOREIGN OBJECT WITH GRASPER."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CANNULA NONE HET APPLIED MEDICAL RESOURCES C0529 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 YR Other