BEUDAMED
    FDA Adverse Event Other Summary report: N

    KARL STORZ

    MDR report key: 1344845 · Received March 11, 2009

    Report

    Report Number
    1061158-2008-00006
    Event Type
    Other
    Date Received
    March 11, 2009
    Date of Event
    January 29, 2009
    Report Date
    March 9, 2009
    Manufacturer
    STORZ MEDICAL AG
    Product Code
    LQR
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    CA
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    TWO DAYS AFTER AN ESWL LITHOTRIPSY PROCEDURE WAS PERFORMED PT ALLEGEDLY RE-ADMITTED TO HOSP FOR FLANK PAIN WHICH WAS A RESULT OF RENAL HEMATOMAS. PT RECOVERED AND WAS RELEASED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KARL STORZ SLX-F2 LQR STORZ MEDICAL AG 13975 *

    Patients

    Seq Age Sex Outcome Treatment
    1 49 YR Other