BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SNOWDEN-PENCER MINI METZ CAREFUSION

    MDR report key: 12633858 · Received October 13, 2021

    Report

    Report Number
    MW5104618
    Event Type
    Injury
    Date Received
    October 13, 2021
    Date of Event
    October 8, 2021
    Report Date
    October 11, 2021
    Manufacturer
    CAREFUSION 2200, INC
    Product Code
    GEI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AZ, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    FRACTURE OF INSTRUMENT TIP INSIDE ABDOMINAL CAVITY. TIP OF CAREFUSION SNOWDEN-PENCER MINI METZ REF (B)(4) LOT 72892 BROKE OFF IN ABDOMINAL CAVITY DURING LAP APPY. ABDOMINAL XRAYS TAKEN BEFORE WOUND CLOSURE AND ALL PARTS RETRIEVED. FDA SAFETY REPORT ID # (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1526362 SNOWDEN-PENCER MINI METZ CAREFUSION ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES GEI CAREFUSION 2200, INC SP8302 72892

    Patients

    Seq Age Sex Outcome Treatment
    1 18 YR Required Intervention