BEUDAMED
    FDA Adverse Event Other Summary report: N

    SERVICE REP,VAS,2.7X67X30DEG35

    MDR report key: 404252 · Received July 3, 2002

    Report

    Report Number
    1216828-2002-00005
    Event Type
    Other
    Date Received
    July 3, 2002
    Date of Event
    June 4, 2002
    Report Date
    July 2, 2002
    Manufacturer
    SMITH & NEPHEW, INC.-ENDOSCOPY DIVI
    Product Code
    HRX
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NE, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    DURING SURGERY THE SCOPE WAS HIT BY ANOTHER DEVICE CAUSING THE DISTAL LENS TO SHATTER IN THE WRIST.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SERVICE REP,VAS,2.7X67X30DEG35 VIDEOARTHROSCOPE HRX SMITH & NEPHEW, INC.-ENDOSCOPY DIVI 3768S *

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other