BEUDAMED
    FDA Adverse Event Injury Summary report: N

    VALLEY LAB

    MDR report key: 513287 · Received February 25, 2004

    Report

    Report Number
    513287
    Event Type
    Injury
    Date Received
    February 25, 2004
    Date of Event
    January 27, 2004
    Report Date
    February 17, 2004
    Manufacturer
    VALLEY LAB
    Product Code
    GEI
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    FIRE STARTED IN LABOR IN DELIVERY AT SURGICAL SITE. PT RECEIVED 2ND DEGREE BURNS TO RIGHT HAND.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VALLEY LAB ELECTRO SURGICAL UNIT (ESU) GEI VALLEY LAB FORCE FX-C *

    Patients

    Seq Age Sex Outcome Treatment
    1 19 YR Hospitalization| R