BEUDAMED
    FDA Adverse Event Injury Summary report: N

    URETEROSCOPE

    MDR report key: 528396 · Received November 18, 2003

    Report

    Report Number
    528396
    Event Type
    Injury
    Date Received
    November 18, 2003
    Date of Event
    September 25, 2003
    Report Date
    October 20, 2003
    Manufacturer
    RICHARD WOLF MEDICAL INSTRUMENTS CORP.
    Product Code
    FGB
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    MA, US
    Reporter Occupation
    RISK MANAGER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 URETEROSCOPE URETEROSCOPE FGB RICHARD WOLF MEDICAL INSTRUMENTS CORP. 8712.402 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 33 YR Required Intervention