BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    STORZ BIPOLAR ADAPTER

    MDR report key: 41703 · Received September 6, 1996

    Report

    Report Number
    1920664-1996-00611
    Event Type
    Malfunction
    Date Received
    September 6, 1996
    Date of Event
    July 22, 1996
    Report Date
    August 8, 1996
    Manufacturer
    STORZ INSTRUMENT CO.
    Product Code
    HQO
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    DURING A CATARACT EXTRACTION PROCEDURE, THIS BIPOLAR ADAPTER COULD NOT BE USED. ANOTHER ADAPTER OR GENERATOR WAS USED TO COMPLETE THE PROCEDURE. THREE ADAPTERS ARE BEING RETURNED FOR EVAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STORZ BIPOLAR ADAPTER BIPOLAR ADAPTER HQO STORZ INSTRUMENT CO. NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO