BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    USA SERIES ACN-1 FLEXIBLE CYSTONEPHROSCOPE

    MDR report key: 230098 · Received June 28, 1999

    Report

    Report Number
    1218764-1999-00012
    Event Type
    Malfunction
    Date Received
    June 28, 1999
    Date of Event
    June 24, 1999
    Report Date
    June 28, 1999
    Manufacturer
    CIRCON ACMI
    Product Code
    FAJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CO, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    REPORTEDLY, DURING SURGERY SOME "WRAPPING" ON SCOPE SHAFT CAME OFF IN PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 USA SERIES ACN-1 FLEXIBLE CYSTONEPHROSCOPE CYSTOSCOPE FAJ CIRCON ACMI ACN-1 NI

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO