BEUDAMED
    FDA Adverse Event Other Summary report: N

    MICROVASIVE

    MDR report key: 168068 · Received May 11, 1998

    Report

    Report Number
    MW1013830
    Event Type
    Other
    Date Received
    May 11, 1998
    Date of Event
    January 22, 1997
    Report Date
    January 24, 1997
    Manufacturer
    BOSTON SCIENTIFIC CORP. MICROVASIVE
    Product Code
    EYA
    Report Source
    Voluntary report
    Reporter Location
    NJ, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    MICROVASIVE RF PA30153 GLIDEWIRE LOT #8895B09 BROKE DURING URETEROSCOPY PROCEDURE. BROKEN PIECE RETRIEVED BY SURGEON UNDER URETEROSCOPIC VISION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MICROVASIVE GLIDEWIRE EYA BOSTON SCIENTIFIC CORP. MICROVASIVE RF PA30153 8895B09

    Patients

    Seq Age Sex Outcome Treatment
    1 33 YR Other