BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TISSUE RETRIEVAL SYSTEM ANCHOR

    MDR report key: 1845007 · Received September 24, 2010

    Report

    Report Number
    MW5017566
    Event Type
    Injury
    Date Received
    September 24, 2010
    Date of Event
    January 1, 2010
    Report Date
    September 24, 2010
    Product Code
    GCJ
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AL, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    DURING A GALL BLADDER OPERATION, SPECIMEN WAS PUT IN A RETRIEVAL BAG. METAL FROM RETRIEVER SYSTEM DISASSEMBLED AND PIECE OF METAL WAS LATER FOUND IN ABDOMEN OF PT. SURGICAL REMOVAL DONE (B)(6)2010 WITH NO KNOWN COMPLICATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TISSUE RETRIEVAL SYSTEM ANCHOR GCJ

    Patients

    Seq Age Sex Outcome Treatment
    1 77 YR Other| R