BEUDAMED
    FDA Adverse Event Other Summary report: N

    KITTNER

    MDR report key: 2232314 · Received August 26, 2011

    Report

    Report Number
    MW5021943
    Event Type
    Other
    Date Received
    August 26, 2011
    Date of Event
    October 26, 2010
    Report Date
    August 26, 2011
    Manufacturer
    TYCO
    Product Code
    GCJ
    Report Source
    Voluntary report
    Reporter Location
    AL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    ENDOSCOPIC KITTNER CAME OFF STICK IN PATIENT. KITTNER RETRIEVED. NO APPARENT INJURY TO PATIENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KITTNER ENDOSCOPIC KITTNER GCJ TYCO M91302

    Patients

    Seq Age Sex Outcome Treatment
    1 47 YR Other