BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CLICKLINE BOWEL GRASPER FORCEP INSERT LAPROSCOPIC BOWEL GRASPER

    MDR report key: 18884946 · Received March 8, 2024

    Report

    Report Number
    MW5152600
    Event Type
    Injury
    Date Received
    March 8, 2024
    Date of Event
    March 1, 2024
    Report Date
    March 6, 2024
    Manufacturer
    KARL STORZ ENDOSCOPY AMERICA, INC.
    Product Code
    GCJ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    RISK MANAGER
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    TWO TINES OF LAPAROSCOPIC BOWEL GRASPER BROKE DURING LAPAROSCOPIC CHOLECYSTECTOMY. REQUIRED INTRAOPERATIVE LOCALIZATION FOR LAPAROSCOPIC REMOVAL. ALL PIECES SUCCESSFULLY REMOVED LAPAROSCOPICALLY. POST REMOVAL X-RAY DEMONSTRATED RESOLUTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    957099 CLICKLINE BOWEL GRASPER FORCEP INSERT LAPROSCOPIC BOWEL GRASPER LAPAROSCOPE, GENERAL & PLASTIC SURGERY GCJ KARL STORZ ENDOSCOPY AMERICA, INC. ZW32

    Patients

    Seq Age Sex Outcome Treatment
    1 36 YR Female Required Intervention