BEUDAMED
    FDA Adverse Event Injury Summary report: N

    OLYMPUS

    MDR report key: 2803251 · Received October 31, 2007

    Report

    Report Number
    2803251
    Event Type
    Injury
    Date Received
    October 31, 2007
    Date of Event
    October 22, 2007
    Report Date
    October 24, 2007
    Manufacturer
    OLYMPUS AMERICA
    Product Code
    FDF
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT HAD A COLONOSCOPY ON (B)(6) 2007. WENT TO ER ON (B)(6) 2007, DID WITH PAN COLITIS. (POSSIBLY DUE TO RAPICIDE SOLUTION?).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 OLYMPUS COLON SCOPE FDF OLYMPUS AMERICA 2112153
    2 OLYMPUS DSD REPROCESSOR, SIDE B FDF OLYMPUS AMERICA 500101

    Patients

    Seq Age Sex Outcome Treatment
    1 43 YR Other