BEUDAMED
    FDA Adverse Event Summary report: N

    *

    MDR report key: 2992129 · Received March 1, 2013

    Report

    Report Number
    2992129
    Date Received
    March 1, 2013
    Date of Event
    February 21, 2013
    Report Date
    February 25, 2013
    Manufacturer
    KARL STORZ ENDOSCOPY
    Product Code
    GEI
    Report Source
    User Facility report
    Reporter Location
    VA, US

    Narratives

    Description of Event or Problem · 1

    THE ELECTROSURGICAL UNIT WAS ATTACHED TO KARL STORZ L-HOOK 26775UF VIA KARL STORZ 26006 M HF CABLE. WHEN THE FOOT PEDAL WAS DEPRESSED, THE CABLE IMMEDIATELY BURNT INTO TWO PIECES. THE CORD WAS REPLACED AND ESU USED WITH NO PROBLEM.WHAT WAS THE ORIGINAL INTENDED PROCEDURE?LOBECTOMY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    89439 * ELECTROSURGICAL, MONOPOLAR CABLE, REUSEABLE GEI KARL STORZ ENDOSCOPY 26006 M *

    Patients

    Seq Age Sex Outcome Treatment
    1 * CORD WAS CONNECTED TO A VALLEYLAB FORCE FX-C ELECT| UF).| ROSURGICAL UNIT AND KARL STORZ L-HOOK (MODEL 26775