FDA Adverse Event Other Summary report: N

CLARUS LASE

MDR report key: 392057 · Received April 29, 2002

Report

Report Number
2183911-2002-00001
Event Type
Other
Date Received
April 29, 2002
Date of Event
March 26, 2002
Report Date
April 26, 2002
Manufacturer
CLARUS MEDICAL, LLC.
Product Code
GEX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
ME, US
Reporter Occupation
RISK MANAGER

Narratives

Description of Event or Problem · 1

TIP OF LASE DEVICE, WHICH IS MADE OF STAINLESS STEEL, CLASS FIBER FOR IMAGE AND PLASTIC FIBER FOR ILLUMINATION AND EPOXY, WAS LEFT IN THE PATIENT. THE LOCATION OF THE TIP AFTER SURGERY WAS INSIDE OF THE SPINAL DISC IN THE LUMAR AREA OF THE SPINE. THE EXACT LEVEL IS NOT KNOWN BY THE MANUFACTURER. MANUFACTURER WAS TOLD THE PATIENT HAD DEGENERATIVE DISC DISEASE. NO PATIENT INJURY WAS REPORTED TO THE MFR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CLARUS LASE ENDOSCOPIC DISECTOMY DEVICE GEX CLARUS MEDICAL, LLC. 1100-002 NA

Patients

Seq Age Sex Outcome Treatment
1 34 YR Other