BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HYDRO-SURG PLUS

    MDR report key: 373494 · Received January 21, 2002

    Report

    Report Number
    373494
    Event Type
    Injury
    Date Received
    January 21, 2002
    Date of Event
    January 14, 2002
    Report Date
    January 17, 2002
    Manufacturer
    BARD/DAVOL, INC
    Product Code
    KQT
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    FL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING LAPAROSCOPIC PROCEDURE DAVOL SUCTION IRRIGATOR BATTERY PAK HAD BATTERY BURN OUT. PACK REPLACED WITH NO EFFECT TO PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HYDRO-SURG PLUS IRRIG. BATTERY PACK KQT BARD/DAVOL, INC * 41JLN046

    Patients

    Seq Age Sex Outcome Treatment
    1 37 YR Required Intervention