BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    WILSON COOK MEDICAL, INC.

    MDR report key: 182105 · Received August 12, 1998

    Report

    Report Number
    MW1014377
    Event Type
    Malfunction
    Date Received
    August 12, 1998
    Date of Event
    July 29, 1998
    Report Date
    July 31, 1998
    Manufacturer
    WILSON COOK MEDICAL, INC.
    Product Code
    FFL
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NY, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT TO HAVE ENDOSCOPIC RETROGRADE CHOLANGIO-PANCREATOGRAPHY. BASKET BROKE WHILE PROCEDURE BEING PERFORMED. PT DID NOT REQUIRE ADDITIONAL PROCEDURE AND SUFFERED NO HARM OR INJURY FROM INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 WILSON COOK MEDICAL, INC. STONE EXTRACTION BASKET FFL WILSON COOK MEDICAL, INC. MB5-2X4-8 943443

    Patients

    Seq Age Sex Outcome Treatment
    1 75 YR