BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LIFE INSTRUMENT CO. 4MM KERRISON RONGEUR

    MDR report key: 20855029 · Received December 4, 2024

    Report

    Report Number
    MW5163225
    Event Type
    Injury
    Date Received
    December 4, 2024
    Date of Event
    November 26, 2024
    Report Date
    November 29, 2024
    Manufacturer
    LIFE INSTRUMENT CORP
    Product Code
    HAO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    KERRISON BROKE DURING SURGERY, BOTH PIECES RETRIEVED, NO HARM TO PATIENT, INSTRUMENT REPLACED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2290683 LIFE INSTRUMENT CO. 4MM KERRISON RONGEUR INSTRUMENT, SURGICAL, NON-POWERED HAO LIFE INSTRUMENT CORP 830-08040-0

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR Male Required Intervention