FDA Adverse Event Other Summary report: N

KARL STORZ

MDR report key: 1586268 · Received January 9, 2010

Report

Report Number
9610617-2010-00001
Event Type
Other
Date Received
January 9, 2010
Date of Event
December 9, 2009
Report Date
January 8, 2010
Manufacturer
KARL STORZ GMBH & CO. KG
Product Code
EOX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

FIRST USE. DEVICES WERE DISPOSED OF AFTER THE CASE.

Description of Event or Problem · 1

ALLEGEDLY, DURING A SIALENDOSCOPY PROCEDURE, THE DOCTOR ENCOUNTERED SEVERE STENOSIS; TWO 4-WIRE 11582MS BROKE; ANOTHER 6-WIRE BASKET WAS TRIED BUT DOCTOR WAS UNABLE TO GET PAST STENOSIS. HE SWITCHED TO AN OPEN PROCEDURE TO REMOVE STONES; THIS ADDED ABOUT AN HOUR TO THE PROCEDURE. DOCTOR FELT ANATOMICAL DIFFICULTIES WERE THE CAUSE RATHER THAN FAILURE OF THE INSTRUMENT. POSSIBLE PT WAS NOT A GOOD CANDIDATE FOR ENDOSCOPY DUE TO SIZE AND PLACEMENT OF STONES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 KARL STORZ ESOPHAGOSCOPE EOX KARL STORZ GMBH & CO. KG 11582M UNK

Patients

Seq Age Sex Outcome Treatment
1 Other