BEUDAMED
    FDA Adverse Event Injury Summary report: N

    GREAT RIVER MEDICAL CENTER D & C VAG HYST PACK

    MDR report key: 8772727 · Received July 8, 2019

    Report

    Report Number
    MW5087959
    Event Type
    Injury
    Date Received
    July 8, 2019
    Date of Event
    June 28, 2019
    Report Date
    July 3, 2019
    Manufacturer
    AMERICAN CONTRACT SYSTEMS
    Product Code
    OHD
    UDI-DI
    00191072042361
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    HAIR FOUND IN CUSTOM D & C VAG HYST PACK WHEN OPENED. WAS ON TOP OF PREP TRAY. FDA SAFETY REPORT ID# (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    559884 GREAT RIVER MEDICAL CENTER D & C VAG HYST PACK GYNECOLOGICAL LAPAROSCOPIC KIT OHD AMERICAN CONTRACT SYSTEMS 898191 00191072042361

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention