BEUDAMED
    FDA Adverse Event Other Summary report: N

    KARL STORZ PEANUT GRASPING FORCEPS

    MDR report key: 446285 · Received February 27, 2003

    Report

    Report Number
    2020550-2003-00002
    Event Type
    Other
    Date Received
    February 27, 2003
    Date of Event
    January 28, 2003
    Report Date
    February 26, 2003
    Manufacturer
    KARL STORZ GMBH & CO KG
    Product Code
    HET
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    CA
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    DURING A PERCUTANEOUS RENAL STONE REMOVAL PROCEDURE, THE PIN THAT HOLDS THE JAW ALLEGEDLY BROKE OFF. DOCTOR TRIED IRRIGATION TO FLUSH PIN OUT BUT WAS NOT CERTAIN THEY WERE SUCCESSFUL. A MAGNIFIED FLUOROSCOPY WAS CONDUCTED AND NOTHING WAS FOUND IN THE KIDNEY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KARL STORZ PEANUT GRASPING FORCEPS PEANUT GRASPING FORCEPS HET KARL STORZ GMBH & CO KG 27090K AK

    Patients

    Seq Age Sex Outcome Treatment
    1 45 YR Other