inforMED
MalfunctionEKD

JACOBSON MICRO MOSQ 5 CV

Received Dec 24, 2014

Report 2523190-2014-00073 · MDR key 4380111

Device

Generic name

M6 - Neuro

Catalog number

17-2602

Lot number

UNK

Product problems

  • Break
  • Detachment Of Device Component

Patient

32 YR

  • No Known Impact Or Consequence To Patient

Narrative

Description of Event or Problem

CUSTOMER INITIALLY REPORTS THE TIP BROKE IN PT ON FIRST USE FROM PACKAGE. ON (B)(6) 2014 CUSTOMER REPORTS DOCTOR WAS PERFORMING A THYROIDECTOMY WHEN HE MANIPULATED THE TIP OF THE DEVICE UNDER A BLOOD VESSEL AND IT BROKE OFF. TIP EASILY RETRIEVED, NO HARM DONE. DOCTOR FELT NO NEED FOR X-RAY.

Additional Manufacturer Narrative

TO DATE THE DEVICE INVOLVED IN THE REPORTED INCIDENT HAS NOT BEEN RECEIVED FOR EVALUATION. AN INVESTIGATION HAS BEEN INITIATED BASED ON THE REPORTED INFORMATION.