FDA Adverse Event Injury Summary report: N

PRECISOR BRONCHO

MDR report key: 1173404 · Received September 23, 2008

Report

Report Number
9710641-2008-00136
Event Type
Injury
Date Received
September 23, 2008
Report Date
July 31, 2008
Manufacturer
DISPOSABLE BIOPSY FORCEPS
Product Code
BTG
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION IS STILL OPEN HOWEVER; THE SAMPLE WAS DISCARDED AT THE FACILITY. SHOULD MORE INFO BECOME AVAILABLE THROUGH THE INVESTIGATION REPORT, A SUPPLEMENTAL REPORT WILL BE FILED.

Description of Event or Problem · 1

IT WAS REPORTED "A TEAR TO THE ESOPHAGUS". NO CLINICAL COMPLICATIONS WERE RECORDED BY DR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PRECISOR BRONCHO NONE BTG DISPOSABLE BIOPSY FORCEPS 0712041

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention