FDA Adverse Event
Injury
Summary report: N
CUTTING LOOP, BIPOLAR, 26 FR.
MDR report key: 22777207
·
Received August 11, 2025
Report
- Report Number
- 2020550-2025-01400
- Event Type
- Injury
- Date Received
- August 11, 2025
- Date of Event
- July 22, 2025
- Report Date
- August 11, 2025
- Manufacturer
- KARL STORZ SE & CO. KG
- Product Code
- HIN
- UDI-DI
- 04048551392720
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Distributor report
- Reporter Location
- NY, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
THE AFFECTED DEVICE WILL NOT RETURN FOR INVESTIGATION DUE TO THE CUSTOMER DID NOT SAVE THE BROKEN ELECTRODES. SHOULD RELEVANT ADDITIONAL INFORMATION / INVESTIGATION RESULTS BECOME AVAILABLE, A SUPPLEMENTAL MEDWATCH REPORT WILL BE SUBMITTED UNSOLICITED. THIS EVENT IS FILED UNDER INTERNAL COMPLAINT ID (B)(4). CROSS REFERENCE INTERNAL COMPLAINT ID (B)(4).
Description of Event or Problem · 0
IT WAS REPORTED DURING A MEDICAL PROCEDURE ON (B)(6) 2025 TWO (2) ELECTRODES BROKE. ACCORDING TO THE DOCTOR, A PIECE WAS RETAINED IN THE PATIENT AND THEY DID NOT SAVE THE BROKEN ELECTRODES. CROSS REFERENCE MEDWATCH NUMBER 2020550-2025-01399.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2159788 | CUTTING LOOP, BIPOLAR, 26 FR. | CUTTING LOOP, BIPOLAR, 26 FR. | HIN | KARL STORZ SE & CO. KG | 26040GP1 | 04048551392720 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown | Other |