BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TENACULUM FORCEPS, RATCHET, 5MM, 32CM

    MDR report key: 957372 · Received November 29, 2007

    Report

    Report Number
    2430952-2007-00051
    Event Type
    Malfunction
    Date Received
    November 29, 2007
    Report Date
    November 29, 2007
    Manufacturer
    KOSCHER & WUERTZ GMBH
    Product Code
    GEN
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    NC, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE INSTRUMENT BROKE DURING USE. THERE WAS NO PATIENT INJURY REPORTED. NO ADDITIONAL INFORMATION WAS PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TENACULUM FORCEPS, RATCHET, 5MM, 32CM FORCEP GEN KOSCHER & WUERTZ GMBH * *

    Patients

    Seq Age Sex Outcome Treatment
    1 *