BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MEMORY SOFT STONE EXTRACTOR

    MDR report key: 105829 · Received July 1, 1997

    Report

    Report Number
    105829
    Event Type
    Injury
    Date Received
    July 1, 1997
    Date of Event
    May 29, 1997
    Report Date
    June 13, 1997
    Manufacturer
    WILSON-COOK
    Product Code
    FFL
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    NH, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    5/29/97 ERCP WITH ATTEMPTED CED CALCULUS REMOVAL. ONCE CALCULUS CAPTURED IN BASKET WIRE CABLE BROKE. PT. TO SURGERY FOR REMOVAL OF WIRE BASKET AND CALCULUS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEMORY SOFT STONE EXTRACTOR CED-STONE RETRIEVOR FFL WILSON-COOK MSB-2XF-F 691839

    Patients

    Seq Age Sex Outcome Treatment
    1 28 YR Required Intervention