BEUDAMED
    FDA Adverse Event Other Summary report: N

    *

    MDR report key: 968382 · Received October 3, 2006

    Report

    Report Number
    968382
    Event Type
    Other
    Date Received
    October 3, 2006
    Date of Event
    July 7, 2006
    Report Date
    August 31, 2006
    Manufacturer
    J AND J CODMAN
    Product Code
    GEN
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NC, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    JACOBS UTERINE VULSELLUM TENACULUM SEATED AROUND HIPBALL TO PULL IT OUT AND SHARP ENDS BENT OFF TENACULUM. PT NOT HARMED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * JACOB'S TENACULUM GEN J AND J CODMAN 30-5605 *

    Patients

    Seq Age Sex Outcome Treatment
    1 46 YR Other