BEUDAMED
    FDA Adverse Event Injury Summary report: N

    COUNTER SINK GUIDE

    MDR report key: 86725 · Received April 25, 1997

    Report

    Report Number
    MW1011210
    Event Type
    Injury
    Date Received
    April 25, 1997
    Date of Event
    April 11, 1997
    Report Date
    April 17, 1997
    Manufacturer
    OSTEOMED CORP.
    Product Code
    HWW
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AZ, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    WHILE USING THE SELF-GUIDED COUNTER SINK, THE DR NOTICED THAT THE 1/8" LONG TIP HAD BROKEN OFF IN THE PT'S FOOT. AFTER SUCTIONING THE AREA EXTENSIVELY, THE PIECE OF METAL WAS RETRIEVED FROM THE SUCTION CANISTER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 COUNTER SINK GUIDE COUNTER SINK GUIDE HWW OSTEOMED CORP. 320-0024 *

    Patients

    Seq Age Sex Outcome Treatment
    1 32 YR Required Intervention