BEUDAMED
    FDA Adverse Event Other Summary report: N

    *

    MDR report key: 409651 · Received August 9, 2002

    Report

    Report Number
    409651
    Event Type
    Other
    Date Received
    August 9, 2002
    Date of Event
    May 28, 2002
    Report Date
    June 5, 2002
    Manufacturer
    J & J CODMAN
    Product Code
    GEI
    Report Source
    User Facility report
    Reporter Location
    SC, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PHYSICIAN WAS PERFORMING TONSILLECTOMY WITH BIPOLAR FORCEPS. THE PT RECEIVED INADVERTENT BURNS TO CORNERS OF MOUTH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * BIPOLAR FORCEPS GEI J & J CODMAN * 092109

    Patients

    Seq Age Sex Outcome Treatment
    1 13 YR Other