BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ETHICON

    MDR report key: 3070432 · Received April 16, 2013

    Report

    Report Number
    MW5029842
    Event Type
    Injury
    Date Received
    April 16, 2013
    Date of Event
    April 15, 2013
    Report Date
    April 15, 2013
    Manufacturer
    ETHICON
    Product Code
    LFL
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NY, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    TIP OF HARMONIC SCALPEL BROKE OFF DURING USE. PIECE FOUND REMOVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    164091 ETHICON HARMONIC LFL ETHICON LCS-C5

    Patients

    Seq Age Sex Outcome Treatment
    1 21 YR Required Intervention