BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CIRCLING BAND 240-STYLE 2.5

    MDR report key: 143710 · Received January 9, 1998

    Report

    Report Number
    1920664-1998-00007
    Event Type
    Malfunction
    Date Received
    January 9, 1998
    Date of Event
    December 10, 1997
    Report Date
    December 10, 1997
    Manufacturer
    STORZ INSTRUMENT COMPANY
    Product Code
    HQX
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CO, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    THIS BAND BROKE WHILE THE PHYSICIAN WAS PERFORMING A SCLERAL BUCKLE PROCEDURE. HE FINISHED THE PROCEDURE USING ANOTHER BAND.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CIRCLING BAND 240-STYLE 2.5 Implant IMPLANT FOR RETINAL DETACHMENT SURGERY HQX STORZ INSTRUMENT COMPANY NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO