BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SEMI-RIDID SCISSORS

    MDR report key: 374440 · Received January 22, 2002

    Report

    Report Number
    1519132-2002-00006
    Event Type
    Malfunction
    Date Received
    January 22, 2002
    Date of Event
    December 20, 2001
    Report Date
    January 22, 2002
    Manufacturer
    CIRCON ACMI
    Product Code
    JOK
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    SMOKE COMING FROM WORKING ELEMENT.

    Description of Event or Problem · 1

    SCISSORS SCREW DETACHED FROM BLADES DURING HYSTEROSCOPY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SEMI-RIDID SCISSORS 500 JOK CIRCON ACMI GYS-5 BD (2/2000)

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO