BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BLADE EXTENDER KIT

    MDR report key: 382503 · Received March 11, 2002

    Report

    Report Number
    1519132-2002-00024
    Event Type
    Injury
    Date Received
    March 11, 2002
    Date of Event
    February 19, 2002
    Report Date
    March 11, 2002
    Manufacturer
    CIRCON ACMI
    Product Code
    EQN
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    TWO BLADE EXTENDER FELL OFF IN PT'S THROAT. BOTH WERE COUGHED UP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BLADE EXTENDER KIT 500 EQN CIRCON ACMI LAR-AE NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO