BEUDAMED
    FDA Adverse Event Other Summary report: N

    STORZ

    MDR report key: 213276 · Received February 10, 1999

    Report

    Report Number
    213276
    Event Type
    Other
    Date Received
    February 10, 1999
    Date of Event
    January 22, 1999
    Report Date
    February 10, 1999
    Manufacturer
    STORZ INSTRUMENT CO
    Product Code
    KAK
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    WI, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    A BRAND NEW QUICKEST PROBE WAS BENT AT THE END BY THE PHYSICIAN TO FACILITATE PASSING IT THROUGH THE RIGHT NARES. WHEN HE PULLED IT OUT A 6MM PIECE WAS BROKEN OFF AND UNABLE TO BE FOUND. X-RAY OF THE HEAD REVEALED IT WAS LODGED SOMEWHERE IN THE RIGHT NARES; POSSIBLY THE TURBINATES. NASAL ENDOSCOPY DID NOT REVEAL THE PIECE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STORZ PROBE, LACRIMAL QUICKEST KAK STORZ INSTRUMENT CO REF# E4220 00 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 36 YR Other