BEUDAMED
    FDA Adverse Event Injury Summary report: N

    KARL STORZ BOWEL GRASPER

    MDR report key: 516082 · Received March 3, 2004

    Report

    Report Number
    MW1031415
    Event Type
    Injury
    Date Received
    March 3, 2004
    Date of Event
    January 9, 2004
    Report Date
    February 26, 2004
    Manufacturer
    CARDINAL HEALTH
    Product Code
    GCJ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NY, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING LAPAROSCOPIC GASTRIC BYPASS, TWO SOFT BOWEL GRASPERS BROKE. THE TWO TIPS OF THE SOFT BOWEL GRASPERS WHICH BROKE OFF INSIDE THE ABODOMINAL CAVITY WERE RECOVERED. THERE WAS NO INJURY OR FURTHER COMPLICATION TO THE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KARL STORZ BOWEL GRASPER SOFT BOWEL GRASPER GCJ CARDINAL HEALTH * *

    Patients

    Seq Age Sex Outcome Treatment
    1 66 YR Required Intervention