BEUDAMED
    FDA Adverse Event Other Summary report: N

    KARL STORZ

    MDR report key: 2410817 · Received January 6, 2012

    Report

    Report Number
    9610617-2012-00001
    Event Type
    Other
    Date Received
    January 6, 2012
    Date of Event
    December 4, 2011
    Report Date
    January 4, 2012
    Manufacturer
    KARL STORZ GMBH & CO. KG
    Product Code
    FGB
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IN, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    ALLEGEDLY, PATIENT RECEIVED BURN (NICKEL SIZE) TO THE TIP OF THE PENIS WHILE SCOPE WAS IN USE AND IN CONTACT WITH PATIENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KARL STORZ URETEROSCOPE FGB KARL STORZ GMBH & CO. KG 27011KA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 49 YR Other