BEUDAMED
    FDA Adverse Event Injury Summary report: N

    STORZ CUTTING LOOP

    MDR report key: 1100628 · Received August 6, 2008

    Report

    Report Number
    MW5007914
    Event Type
    Injury
    Date Received
    August 6, 2008
    Date of Event
    July 23, 2008
    Report Date
    August 6, 2008
    Manufacturer
    KARL STORZ ENDOSCOPY AMERICA INC.
    Product Code
    FAS
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    LA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    MD WAS USING 24 FR LOOP. TWO LOOPS BROKE WHILE INSIDE PATIENT'S BLADDER. FIRST PIECE RETRIEVED BY MD. SECOND PIECE WASHED OUT OF BLADDER WITH IRRIGATION. NO PIECES REMAINED IN PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STORZ CUTTING LOOP STORZ CUTTING LOOP FAS KARL STORZ ENDOSCOPY AMERICA INC. 34383

    Patients

    Seq Age Sex Outcome Treatment
    1 Disability