BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    RADIAL JAW

    MDR report key: 518124 · Received February 5, 2004

    Report

    Report Number
    6000123-2004-00005
    Event Type
    Malfunction
    Date Received
    February 5, 2004
    Date of Event
    November 10, 2003
    Report Date
    November 13, 2003
    Manufacturer
    BOSTON SCIENTIFIC CORP./BOSTON SCIENTIFIC
    Product Code
    KNW
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FR
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT DURING A PROCEDURE FOR DIAGNOSIS, THE NURSE WAS PRICKED WHEN PUTTING THE SMAPLE IN THE FLASK OF FORMALIN WITH A WIRE PROTRUDING FROM THE FORCEPS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RADIAL JAW NON-CAUTERY PULMONARY FORCEPS KNW BOSTON SCIENTIFIC CORP./BOSTON SCIENTIFIC NA 553916

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Required Intervention