BEUDAMED
    FDA Adverse Event Other Summary report: N

    KARL STORZ TAKE-APART FORCEPS INSERT

    MDR report key: 40912 · Received September 3, 1996

    Report

    Report Number
    2020550-1996-00023
    Event Type
    Other
    Date Received
    September 3, 1996
    Date of Event
    May 18, 1996
    Report Date
    September 3, 1996
    Manufacturer
    KARL STORZ GMBH & CO.
    Product Code
    GEN
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    IL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING A LAPAROSCOPIC CHOLECYSTECTOMY PROCEDURE, THE JAW OF THE FORCEPS BROKE OFF AND WAS NOT RETRIEVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KARL STORZ TAKE-APART FORCEPS INSERT FORCEPS GEN KARL STORZ GMBH & CO. 30430UL EP

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other