BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    *

    MDR report key: 519471 · Received March 17, 2004

    Report

    Report Number
    MW1031563
    Event Type
    Malfunction
    Date Received
    March 17, 2004
    Date of Event
    January 28, 2004
    Report Date
    March 17, 2004
    Manufacturer
    STORZ
    Product Code
    HNQ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TN, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    DURING AN EYE PROCEDURE IN 2004, THE TIP OF KUGLAN - HOOK BROKE IN THE EYE. THE BROKEN TIP WAS RETRIEVED. THERE WERE NO PT COMPLICATIONS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * KUGLAN-HOOK-STORZ HNQ STORZ * *

    Patients

    Seq Age Sex Outcome Treatment
    1 81 YR