BEUDAMED
    FDA Adverse Event Other Summary report: N

    KARL STORZ

    MDR report key: 2071933 · Received April 20, 2011

    Report

    Report Number
    9610617-2011-00017
    Event Type
    Other
    Date Received
    April 20, 2011
    Date of Event
    March 31, 2011
    Report Date
    April 18, 2011
    Manufacturer
    KARL STORZ GMBH & CO. KG
    Product Code
    CCW
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    ALLEGEDLY, AT THE CONCLUSION OF A DIRECT LARYNGOSCOPY BRONCHOSCOPY AND DILATION OF SUB GLOTTIS STENOSIS PROCEDURE THAT LASTED 40 MINS, THE DOCTOR REMOVED LARYNGOSCOPE AND NOTED THAT THERE WAS A 1 CM BURN ON PT'S LOWER LIP. PLASTIC SURGEON CALLED IN FOR CONSULT AND CATEGORIZED IT AS A 1ST DEGREE BURN THAT COULD BE ADDRESSED WITH ANTIBIOTIC CREAM. CREAM WAS APPLIED AND PT RELEASED THE SAME DAY. PT CONDITION GOOD. PROCEDURE WAS COMPLETED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KARL STORZ LARYNGOSCOPE CCW KARL STORZ GMBH & CO. KG 8576E MA

    Patients

    Seq Age Sex Outcome Treatment
    1 5 MO Other