BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ALCON SHIELDED BULLET ILLUMINATOR

    MDR report key: 3030387 · Received March 27, 2013

    Report

    Report Number
    MW5029549
    Event Type
    Injury
    Date Received
    March 27, 2013
    Report Date
    March 27, 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 PT CARE. THIS IS THE NINTH TIME THIS HAS OCCURRED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    125303 ALCON SHIELDED BULLET ILLUMINATOR SHIELDED BULLET ENDO ILLUMINATOR HQB ALCON SURGICAL 901490M

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention