BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POLYPECTOMY SNARE

    MDR report key: 29490 · Received January 25, 1996

    Report

    Report Number
    MW1008182
    Event Type
    Malfunction
    Date Received
    January 25, 1996
    Date of Event
    January 17, 1996
    Report Date
    January 25, 1996
    Manufacturer
    U.S. ENDOSCOPY GROUP, INC.
    Product Code
    FDI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    THREE SNARES BUCKLED AT THE HANDLE WIRE WHEN OPENED DURING PROCEDURE. SNARE FROM A DIFFERENT LOT NUMBER USED WITHOUT PROBLEM. NO INJURY TO PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 POLYPECTOMY SNARE POLYPECTOMY SNARE FDI U.S. ENDOSCOPY GROUP, INC. 174307

    Patients

    Seq Age Sex Outcome Treatment
    1 71 YR