BEUDAMED
    FDA Adverse Event Other Summary report: N

    89-2117 GENERAL MINOR VALUE SET

    MDR report key: 373935 · Received January 22, 2002

    Report

    Report Number
    2320762-2002-00001
    Event Type
    Other
    Date Received
    January 22, 2002
    Date of Event
    December 26, 2001
    Report Date
    December 28, 2001
    Manufacturer
    DEROYAL INDUSTRIES, INC.
    Product Code
    LRO
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CT, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    WHILE SURGEON ACTIVATED PENCIL COAGULATOR BUTTON, THE CERTIFIED REGISTERED NURSE ANESTHETIST FELT A SHOCK WHILE TOUCHING THE PATIENT. THE HOSPITAL STATED THAT THE PENCIL WILL BE RETURNED ONCE THEY COMPLETE THEIR INVESTIGATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 89-2117 GENERAL MINOR VALUE SET GBC MANAGED CHOICE BASIN GENERAL LRO DEROYAL INDUSTRIES, INC. NA 644578

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other| R