BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VALLEY LAB

    MDR report key: 168384 · Received May 19, 1998

    Report

    Report Number
    MW1013842
    Event Type
    Malfunction
    Date Received
    May 19, 1998
    Date of Event
    February 5, 1998
    Report Date
    April 29, 1998
    Manufacturer
    VALLEY LAB INC.
    Product Code
    KNS
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    FL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT JERKED DURING COLONOSCOPY WHEN HOT BIOPSY FORCEP DELIVERED CAUTERY TO POLYP VIA VALLEY LAB FORCE 18 GENERATOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VALLEY LAB BOVIE KNS VALLEY LAB INC. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 37 YR Other