BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    STORZ

    MDR report key: 1951133 · Received January 3, 2011

    Report

    Report Number
    MW5018861
    Event Type
    Malfunction
    Date Received
    January 3, 2011
    Date of Event
    December 21, 2010
    Report Date
    December 22, 2010
    Product Code
    KNS
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    GA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    DURING TURP CUTTING LOOPS BROKE X3. DATE OF USE: (B)(6) 2010. DIAGNOSIS OR REASON FOR USE: BPH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STORZ CUTTING LOOP KNS 27050G 40762
    2 STORZ CUTTING LOOP KNS 40762
    3 STORZ CUTTING LOOP KNS 37145

    Patients

    Seq Age Sex Outcome Treatment
    1