BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    STORZ O'BRIEN FIXATION FORCEPS

    MDR report key: 56761 · Received September 27, 1996

    Report

    Report Number
    1932180-1996-00077
    Event Type
    Malfunction
    Date Received
    September 27, 1996
    Date of Event
    August 28, 1996
    Report Date
    August 30, 1996
    Manufacturer
    STORZ INSTRUMENT COMPANY
    Product Code
    HNR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    DURING AN INCISION OF A CYST, ONE PRONG BROKE OFF OF THIS INSTRUMENT. ANOTHER INSTRUMENT WAS USED TO COMPLETE THE PROCEDURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STORZ O'BRIEN FIXATION FORCEPS OPHTHALMIC FORCEPS HNR STORZ INSTRUMENT COMPANY NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO