FDA Adverse Event Other Summary report: N

FUNDUS FCPS DA 5MM INLINE

MDR report key: 489778 · Received September 15, 2003

Report

Report Number
8010877-2003-00002
Event Type
Other
Date Received
September 15, 2003
Report Date
September 8, 2003
Manufacturer
KOSCHER & WURTZ GMBH
Product Code
HCZ
Report Source
Manufacturer report
Reporter Occupation
INVALID DATA

Narratives

Description of Event or Problem · 1

THE DISTRIBUTOR REPORTED THAT ON BOTH INSTRUMENTS THE HINGE BROKE DURING USE. THERE WAS NO PT INJURY WHATSOEVER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FUNDUS FCPS DA 5MM INLINE * HCZ KOSCHER & WURTZ GMBH * 0300084

Patients

Seq Age Sex Outcome Treatment
1 *