BEUDAMED
    FDA Adverse Event Death Summary report: N

    KARL STORZ INSUFFLATOR

    MDR report key: 34076 · Received May 24, 1996

    Report

    Report Number
    2020550-1996-00011
    Event Type
    Death
    Date Received
    May 24, 1996
    Date of Event
    May 13, 1996
    Report Date
    May 23, 1996
    Manufacturer
    KARL STORZ ENDOSCOPY-AMERICA, INC.
    Product Code
    FCX
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    DURING A LAPAROSCOPIC "NISSEN" ANTIREFLUX PROCEDURE, PT HAD PULMONARY EMBOLISM AND EXPIRED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KARL STORZ INSUFFLATOR INSUFFLATOR FCX KARL STORZ ENDOSCOPY-AMERICA, INC. 26012C

    Patients

    Seq Age Sex Outcome Treatment
    1 * Death