BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SLIMLINE EZ

    MDR report key: 1210883 · Received October 23, 2008

    Report

    Report Number
    MW5008732
    Event Type
    Injury
    Date Received
    October 23, 2008
    Date of Event
    October 15, 2008
    Report Date
    October 23, 2008
    Manufacturer
    SLIMLINE EZ
    Product Code
    LNK
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NY, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DEVICE USED TO RETRIEVE (LEFT) KIDNEY STONE CALLED 200 LASER - SLIMLINE EZ, BROKE INTO 2 PIECES DURING PROCEDURE - BOTH PIECES RETRIEVED FROM THE PT IMMEDIATELY - NO PERMANENT HARM TO PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SLIMLINE EZ DEVICE USED FOR KIDNEY STONES LNK SLIMLINE EZ 78260708

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Required Intervention