BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    STRYKER ENDOSCOPY

    MDR report key: 477268 · Received August 4, 2003

    Report

    Report Number
    MW1029225
    Event Type
    Malfunction
    Date Received
    August 4, 2003
    Date of Event
    May 19, 2003
    Report Date
    August 1, 2003
    Manufacturer
    STRYKER ENDOSCOPY
    Product Code
    KOG
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AZ, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    LAPAROSCOPIC BILATERAL INGUINAL HERNIA REPAIR. IN PROCESS OF DISSECTING, ENDOSHEARS SCISSORS BROKE; PART WAS RETRIEVED IMMEDIATELY. AREA AROUND HINGE PIN HAD CRACKED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STRYKER ENDOSCOPY INSERT OF ENDOSHEARS KOG STRYKER ENDOSCOPY 250-080-267 *

    Patients

    Seq Age Sex Outcome Treatment
    1 19 YR