BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SMART FLEX PROBE

    MDR report key: 1738014 · Received June 22, 2010

    Report

    Report Number
    MW5016490
    Event Type
    Injury
    Date Received
    June 22, 2010
    Date of Event
    June 17, 2010
    Report Date
    June 22, 2010
    Manufacturer
    PEREGRINE
    Product Code
    HXB
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NC, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PRODUCT BROKE OFF IN THE PT'S EYE. TOOK AN EXTRA 2 HOURS TO RETRIEVE PIECES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SMART FLEX PROBE HXB PEREGRINE 920228

    Patients

    Seq Age Sex Outcome Treatment
    1 32 YR Disability