BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LIGHT SOURCE, PSX 300

    MDR report key: 376397 · Received February 13, 2002

    Report

    Report Number
    1038548-2002-00002
    Event Type
    Injury
    Date Received
    February 13, 2002
    Date of Event
    December 18, 2001
    Report Date
    January 29, 2002
    Manufacturer
    SNOWDEN PENCER, INC.
    Product Code
    FCW
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    END PIECE OF RETRACTOR THAT HOOKS UP TO THE LIGHTSOURCE BURNED THE PATIENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIGHT SOURCE, PSX 300 * FCW SNOWDEN PENCER, INC. 89-8700 *

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other