BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SNAP-IN SNAP-OUT LAPAROSCOPIC INSTRUMENT

    MDR report key: 183895 · Received August 20, 1998

    Report

    Report Number
    9680400-1998-00003
    Event Type
    Malfunction
    Date Received
    August 20, 1998
    Report Date
    August 20, 1998
    Manufacturer
    LICAN MEDICAL PRODUCTS
    Product Code
    GCJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SD, US
    Reporter Occupation
    NO INFORMATION

    Narratives

    Description of Event or Problem · 1

    INSULATION REPORTEDLY FLAKING OFF METAL SHAFT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SNAP-IN SNAP-OUT LAPAROSCOPIC INSTRUMENT LAPAROSCOPIC INSTRUMENT GCJ LICAN MEDICAL PRODUCTS LA 8113 NI

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO CIRCON ACMI OPTIMA II LAPAROSCOPIC HAND INSTRUMENT