BEUDAMED
    FDA Adverse Event Summary report: N

    STORZ LEIVERS MOUTH GAG FRAME, CHILD SIZE

    MDR report key: 49451 · Received November 14, 1996

    Report

    Report Number
    1932180-1996-00106
    Date Received
    November 14, 1996
    Date of Event
    September 17, 1996
    Report Date
    October 17, 1996
    Manufacturer
    STORZ INSTRUMENT CO.
    Product Code
    KBN
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    DURING A TONSILLECTOMY, THE THUMB LATCH SPRING WAS CRACKED. THE PROCEDURE WAS DELAYED LONG ENOUGH TO SWITCH TO A DIFFERENT INSTRUMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STORZ LEIVERS MOUTH GAG FRAME, CHILD SIZE MOUTH GAG KBN STORZ INSTRUMENT CO. NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO