BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CRAWFORD

    MDR report key: 284453 · Received June 30, 2000

    Report

    Report Number
    284453
    Event Type
    Injury
    Date Received
    June 30, 2000
    Date of Event
    June 23, 2000
    Report Date
    June 27, 2000
    Manufacturer
    WALSH MANUFACTURING LTD.
    Product Code
    HNW
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    IL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THIS IS A PT WHO UNDERWENT A DACRYOCYSTORHINOSTOMY ON THE RIGHT SIDE. A LACRIMAL INTUBATION SET WAS USED AND ABOUT HALF OF THE WIRE BROKE OFF AND REMAINED IN THE PT'S NOSTRIL. THE PT WILL RETURN TO SURGERY IN 10 DAYS FOR REMOVAL OF FOREIGN BODY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CRAWFORD LACRIMAL INTUBATION SET HNW WALSH MANUFACTURING LTD. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 88 YR Required Intervention