BEUDAMED
    FDA Adverse Event Other Summary report: N

    KARL STORZ

    MDR report key: 1289343 · Received December 4, 2008

    Report

    Report Number
    2020550-2008-00029
    Event Type
    Other
    Date Received
    December 4, 2008
    Date of Event
    August 15, 2008
    Report Date
    December 2, 2008
    Manufacturer
    KARL STORZ ENDOVISION
    Product Code
    FFS
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    MI, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    HOSP REPORTS THAT DURING A PROCEDURE IT WAS ALLEGED THAT ACTIVE LIGHT CABLE WAS LAID ON PT'S DRAPE. THE DRAPE AND PT'S BLANKET WERE BURNED. THERE WAS NO IMPACT ON THE PT. NO MALFUNCTION OF CABLE REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KARL STORZ LIGHT CABLE FFS KARL STORZ ENDOVISION 495ND NA

    Patients

    Seq Age Sex Outcome Treatment
    1 68 YR Other