BEUDAMED
    FDA Adverse Event Summary report: N

    KLEPPINGER FORCEPS

    MDR report key: 16465 · Received September 28, 1994

    Report

    Report Number
    MW1003523
    Date Received
    September 28, 1994
    Date of Event
    September 6, 1994
    Report Date
    September 7, 1994
    Manufacturer
    RICHARD WOLF MEDICAL INSTRUMENT CORP.
    Product Code
    FJR
    Report Source
    Voluntary report
    Reporter Location
    LA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    THE FORCEPS IS ATTACHED TO A BIPOLAR CORD AT THE BACK OF THE INSTRUMENT. THE PROCEDURE IS PERFORMED. THEN, WHEN THE CORD IS REMOVED FROM THE FORCEPS FOR CLEANING, PART OF THE FORCEPS BREAKS OFF AND REMAINS STUCK INSIDE THE BIPOLAR CORD. IT COSTS THE FACILITY $658.00 TO REPLACE THE TWO ITEMS. (SEE ALSO 1003524.)

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KLEPPINGER FORCEPS FJR RICHARD WOLF MEDICAL INSTRUMENT CORP.

    Patients

    Seq Age Sex Outcome Treatment
    1 *