BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SENSOR NITINOL WIRE WITH HYDROPHILIC TIP (STRAIGHT TIP)

    MDR report key: 1894061 · Received November 2, 2010

    Report

    Report Number
    MW5018066
    Event Type
    Injury
    Date Received
    November 2, 2010
    Date of Event
    November 2, 2010
    Report Date
    November 2, 2010
    Manufacturer
    BOSTON SCIENTIFIC
    Product Code
    EZB
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    GA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    DURING URETEROSCOPY, END OF GUIDEWIRE (HYDROPHILIC COATING) CAME OFF. THIS WAS RETRIEVED. DATES OF USE: (B)(6) 2010. DIAGNOSIS OR REASON FOR USE: LEFT URETERAL STONE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SENSOR NITINOL WIRE WITH HYDROPHILIC TIP (STRAIGHT TIP) SENSOR EZB BOSTON SCIENTIFIC 670-305 13773502

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Required Intervention