BEUDAMED
    FDA Adverse Event Injury Summary report: N

    5MM X 32CM, A-TRAC LAPAROSCOPIC GRASPER

    MDR report key: 360237 · Received November 14, 2001

    Report

    Report Number
    2027111-2001-00035
    Event Type
    Injury
    Date Received
    November 14, 2001
    Report Date
    November 13, 2001
    Manufacturer
    APPLIED MEDICAL RESOURCES
    Product Code
    GCF
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SF
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE JAWS OF THE GRASPER OUT OF ALIGNMENT AND AS A RESULT THE DOCTOR DAMAGED A FALLOPIAN TUBE. CAUTERY ON THE FALLOPIAN TUBE WAS USED AS MEDICAL INTERVENTION. IN FOLLOWING UP, THERE WAS NO PERMANENT INJURY OR PATIENT COMPLICATIONS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    51473 5MM X 32CM, A-TRAC LAPAROSCOPIC GRASPER A-TRAC GRASPER GCF APPLIED MEDICAL RESOURCES C5208 EOM028

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention