BEUDAMED
    FDA Adverse Event Injury Summary report: N

    OLYMPUS 24FRENCH

    MDR report key: 1990016 · Received February 9, 2011

    Report

    Report Number
    MW5019384
    Event Type
    Injury
    Date Received
    February 9, 2011
    Date of Event
    January 31, 2011
    Report Date
    February 9, 2011
    Manufacturer
    NA
    Product Code
    FAJ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NC, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    CERAMIC TIP OF OLYMPUS TRANSURETHRAL SHEATH BROKE OFF. A 24FR, A2204A, CRUSHED BY SURGEON INTENTIONALLY & FLUSHED WITH IRRIGATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 OLYMPUS 24FRENCH A2204A FAJ NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 68 YR Hospitalization