BEUDAMED
    FDA Adverse Event Injury Summary report: N

    RASPIT

    MDR report key: 313951 · Received January 24, 2001

    Report

    Report Number
    MW1020927
    Event Type
    Injury
    Date Received
    January 24, 2001
    Date of Event
    January 23, 2001
    Report Date
    January 24, 2001
    Manufacturer
    BOSTON SCIENTIFIC MICROVASIVE
    Product Code
    FFL
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CO, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT UNDERGOING LITHOTRIPSY PROCEDURE. RENAL STONE MOVED INTO URETER. GRASPIT FORCEP THEN USED TO SNARE STONE AND REMOVE. UPON APPLYING GRASPIT FORCEP BASKET PORTION BROKE FREE OF INSTRUMENT, BECOMING LODGED IN PT URETER. OPEN PROCEDURE THEN BEGUN FOR REMOVAL OF URETER STONE AND INSTRUMENT PIECE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    3013 RASPIT UROLOGICAL GRASPING FORCEPS FFL BOSTON SCIENTIFIC MICROVASIVE M00632040020 3495902

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Hospitalization