BEUDAMED
    FDA Adverse Event Injury Summary report: N

    KERRISON RONGEUR, X-SMALL, SZ 0

    MDR report key: 412566 · Received August 23, 2002

    Report

    Report Number
    1423507-2002-00109
    Event Type
    Injury
    Date Received
    August 23, 2002
    Date of Event
    August 5, 2002
    Report Date
    August 20, 2002
    Manufacturer
    ALLEGIANCE HEALTHCARE CORP
    Product Code
    KBB
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    DURING AN EYE CASE, THE TIP OF THE DEVICE BROKE OFF, AS THE PHYSICIAN WAS CHIPPING AT BONE FOR THE PURPOSE OF INSERTING TUBES. THE PHYSICIAN WAS NOT ABLE TO RETRIEVE THE FOREIGN BODY. THE PT IS SCHEDULED TO HAVE FOREIGN BODY REMOVED AT LATER DATE BY AN ENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KERRISON RONGEUR, X-SMALL, SZ 0 INSTRUMENT KBB ALLEGIANCE HEALTHCARE CORP AU6769 X02

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other| R