BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LAPAROSCOPIC BOWEL CLAMP

    MDR report key: 1659042 · Received April 9, 2010

    Report

    Report Number
    1659042
    Event Type
    Injury
    Date Received
    April 9, 2010
    Date of Event
    March 23, 2010
    Report Date
    April 5, 2010
    Manufacturer
    KARL STORZ
    Product Code
    GEN
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NC, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    ON (B)(6) 2010, THE PT WAS UNDERGOING A LAPAROSCOPIC ROBOTIC ASSISTED MYOMECTOMY. DURING THE PROCEDURE ONE JAW OF THE BOWEL GRASPER BROKE AND FELL INTO THE ABDOMEN. THE SURGEON LOCATED THE BROKEN PIECE AND SUCCESSFULLY REMOVED THE PIECE USING A LAPAROSCOPIC MAGNET.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LAPAROSCOPIC BOWEL CLAMP GRASPING FORCEPS GEN KARL STORZ

    Patients

    Seq Age Sex Outcome Treatment
    1 37 YR Required Intervention