BEUDAMED
    FDA Adverse Event Injury Summary report: N

    5MM, 33CM ENDO METZENBAUM SCISSORS (CURVED)

    MDR report key: 1812018 · Received August 18, 2010

    Report

    Report Number
    2936485-2010-00644
    Event Type
    Injury
    Date Received
    August 18, 2010
    Date of Event
    July 26, 2010
    Report Date
    July 30, 2010
    Manufacturer
    STRYKER ENDOSCOPY SAN JOSE
    Product Code
    LRW
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CH
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    ADDITIONAL INFORMATION WILL BE PROVIDED ONCE THE INVESTIGATION IS COMPLETED.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE UNIT BROKE DURING A LAPAROSCOPIC PROCEDURE. IT WAS FURTHER REPORTED THAT THE BROKEN FRAGMENT WAS ABOUT 1-2 MM IN SIZE AND WAS STILL IN THE BODY OF THE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 5MM, 33CM ENDO METZENBAUM SCISSORS (CURVED) SCISSORS LRW STRYKER ENDOSCOPY SAN JOSE 0846009

    Patients

    Seq Age Sex Outcome Treatment
    1 25 YR Other