BEUDAMED
    FDA Adverse Event Other Summary report: N

    CIRCON ACMI

    MDR report key: 122205 · Received August 26, 1997

    Report

    Report Number
    122205
    Event Type
    Other
    Date Received
    August 26, 1997
    Date of Event
    August 13, 1997
    Report Date
    August 20, 1997
    Manufacturer
    CIRCON ACMI
    Product Code
    FFK
    Report Source
    User Facility report
    Reporter Location
    MI, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    ELECTROHYDRAULIC LITHOTRIP PROBE BROKE OFF INSIDE PT DURING SURGERY. UNABLE TO RETRIEVE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CIRCON ACMI ELECTROHYDRAULIC LITHOTRIP PROBE FFK CIRCON ACMI 2A-0014-0895 CA7075

    Patients

    Seq Age Sex Outcome Treatment
    1 81 YR Other