BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    LID SPECULUM

    MDR report key: 120686 · Received September 15, 1997

    Report

    Report Number
    1932180-1997-00079
    Event Type
    Malfunction
    Date Received
    September 15, 1997
    Date of Event
    August 18, 1997
    Report Date
    August 18, 1997
    Manufacturer
    STORZ INSTRUMENT COMPANY
    Product Code
    HNC
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    THIS SPECULUM BROKE DURING A CATARACT PROCEDURE. THERE WAS NO PT INJURY. ANOTHER SPECULUM WAS USED FOR THE PROCEDURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LID SPECULUM SPECULUM HNC STORZ INSTRUMENT COMPANY NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO