BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    *

    MDR report key: 2895235 · Received November 6, 2012

    Report

    Report Number
    2895235
    Event Type
    Malfunction
    Date Received
    November 6, 2012
    Date of Event
    November 2, 2012
    Report Date
    November 5, 2012
    Manufacturer
    KARL STORZ
    Product Code
    EOX
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    MO, US

    Narratives

    Description of Event or Problem · 1

    BASKET WOULD NOT DEPLOY. THE DEVICE WAS GIVEN TO RESOURCE NURSE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * DISLODGER, STONE BASKET EOX KARL STORZ 11582M S435B

    Patients

    Seq Age Sex Outcome Treatment
    1 66 YR