BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ALCON

    MDR report key: 2978473 · Received February 18, 2013

    Report

    Report Number
    MW5029083
    Event Type
    Injury
    Date Received
    February 18, 2013
    Report Date
    February 18, 2013
    Manufacturer
    ALCON SURGICAL
    Product Code
    HQB
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MN, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    HANDLE AND FIBER OPTICS FOR SHIELDED BULLETT ENDO ILLUMINATOR SEPARATE WHILE BEING USED FOR PATIENT CARE. THIS HAS OCCURRED AT LEAST 8 TIMES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    71005 ALCON SHIELDED BULLET ENDO ILLUMINATOR PRODUCT 8065109203 HQB ALCON SURGICAL 901490M

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention