BEUDAMED
    FDA Adverse Event Injury Summary report: N

    RBLF LASER FIBER

    MDR report key: 2159041 · Received March 10, 2006

    Report

    Report Number
    MW5021284
    Event Type
    Injury
    Date Received
    March 10, 2006
    Date of Event
    January 19, 2004
    Report Date
    February 14, 2006
    Manufacturer
    LASER PERIPHERALS, LLC
    Product Code
    LNK
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IS
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    CUSTOMER STATES FIBER BROKE MID-SHAFT OF FIBER AT LOCATION OF PROXIMAL END OF ENDOSCOPE. PHYSICIAN WAS "BURNED" AT TIME OF FRACTURE. THE INJURY TO PHYSIICAN WAS MINOR AND HE DID CONTINUE PROCEDURE WITH ANOTHER FIBER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RBLF LASER FIBER SURGICAL LASER FIBER LNK LASER PERIPHERALS, LLC RBLF-200 LP-299

    Patients

    Seq Age Sex Outcome Treatment
    1 UK Other