BEUDAMED
    FDA Adverse Event Other Summary report: N

    KARL STORZ LIGHT CABLE

    MDR report key: 567268 · Received January 17, 2005

    Report

    Report Number
    2020550-2005-00001
    Event Type
    Other
    Date Received
    January 17, 2005
    Date of Event
    November 17, 2004
    Report Date
    January 17, 2005
    Manufacturer
    KARL STORZ ENDOVISION
    Product Code
    FFZ
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    IL, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT IN O.R. FOR DIAGNOSTIC LAPAROSCOPY. LIGHT SOURCE TURNED ON (CIRCULATOR THOUGH SHE HEARD TO TURN IT ON). LIGHT SOURCE WAS NOT READY TO BE USED SO CABLE WAS LAID ON DRAPE COVERING PT FACE. LIGHT CABLE BURNED HOLE IN DRAPE AND PT SUSTAINED BURN TO LEFT CHEEK. PT SEEN BY PLASTIC SURGEON. BURN APPEARS TO BE THIRD DEGREE AT CENTER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KARL STORZ LIGHT CABLE LIGHT CABLE FFZ KARL STORZ ENDOVISION 495NL *

    Patients

    Seq Age Sex Outcome Treatment
    1 25 YR Other