BEUDAMED
    FDA Adverse Event Other Summary report: N

    ESCAPE

    MDR report key: 16673273 · Received April 4, 2023

    Report

    Report Number
    16673273
    Event Type
    Other
    Date Received
    April 4, 2023
    Date of Event
    August 4, 2021
    Report Date
    August 19, 2021
    Manufacturer
    BOSTON SCIENTIFIC CORPORATION
    Product Code
    FFL
    Report Source
    User Facility report
    Reporter Location
    PA
    Reporter Occupation
    RISK MANAGER
    Health Professional
    N

    Narratives

    Description of Event or Problem · 0

    WHILE SURGEON REMOVING DEVICE FROM PATIENT THE DEVICE BROKE INSIDE OF THE PATIENT¿S URETHRA AND WAS REMOVED BY THE SURGEON. ALL PIECES WERE OBTAINED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1086898 ESCAPE DISLODGER, STONE, BASKET, URETERAL, METAL FFL BOSTON SCIENTIFIC CORPORATION M0063902010 27542688

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown