BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ALLIGATOR FORCEPS

    MDR report key: 14935 · Received July 28, 1994

    Report

    Report Number
    MW1002958
    Event Type
    Injury
    Date Received
    July 28, 1994
    Date of Event
    July 11, 1994
    Report Date
    July 18, 1994
    Manufacturer
    KARL STORZ ENDOSCOPY-AMERICA, INC.
    Product Code
    FJR
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    DURING A LAPAROSCOPIC CHOLECYSTECTOMY THE GRASPING END OF THE FORCEPS BROKE OFF FALLING INTO ABDOMEN OF PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ALLIGATOR FORCEPS GRASPER FJR KARL STORZ ENDOSCOPY-AMERICA, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 51 YR Required Intervention