FDA Adverse Event
Injury
Summary report: N
POWER LED SAPHIRA, OPAL1 PDD
MDR report key: 18488831
·
Received January 10, 2024
Report
- Report Number
- 2020550-2024-00001
- Event Type
- Injury
- Date Received
- January 10, 2024
- Date of Event
- December 19, 2023
- Report Date
- January 10, 2024
- Manufacturer
- KARL STORZ SE & CO. KG
- Product Code
- OAY
- Adverse Event
- Yes
- Report Source
- Distributor report
- Reporter Location
- CA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 0
THE DEVICE WILL BE FORWARDED TO THE MANUFACTURING SITE FOR INVESTIGATION. SHOULD RELEVANT ADDITIONAL INFORMATION / INVESTIGATION RESULTS BECOME AVAILABLE, A SUPPLEMENTAL MEDWATCH REPORT WILL BE SUBMITTED UNSOLICITED. THIS EVENT IS FILED UNDER INTERNAL COMPLAINT ID (B)(4).
Description of Event or Problem · 0
IT WAS REPORTED THAT BEFORE A CASE ON DEC-19-2023, AN EMPLOYEE WAS CUT HANDLING THE DEVICE (THE FRONT OF THE DEVICE WAS BROKEN). THERE WAS NO PATIENT INVOLVEMENT, AND NO FURTHER INFORMATION WAS PROVIDED ABOUT THE INJURY OF THE EMPLOYEE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 706000 | POWER LED SAPHIRA, OPAL1 PDD | LED LIGHT SOURCE, | OAY | KARL STORZ SE & CO. KG | TL410US |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Unknown | Other |