BEUDAMED
    FDA Adverse Event Other Summary report: N

    KLEPPINGER BIPOLAR FORCEPS

    MDR report key: 572294 · Received February 7, 2005

    Report

    Report Number
    1418479-2005-00007
    Event Type
    Other
    Date Received
    February 7, 2005
    Date of Event
    December 30, 2004
    Report Date
    February 1, 2005
    Manufacturer
    RICHARD WOLF MEDICAL INSTRUMENTS CORP.
    Product Code
    HIN
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NV, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    AFTER TUBAL LIGATION PROCEDURE, PT WOKE UP WITH MINOR BURNS ON THE OUTSIDE OF THEIR LEFT SIDE AND SMALL BLISTERS ON THEIR LEFT ARM. THERE WAS NO COMPLICATIONS OR UNNORMAL OCCURRENCE DURING THE PROCEDURE, THAT COULD HAVE LED TO PT BURN, ACCORDING TO USER FACILITY CONTACT. PT WAS WRAPPED PROPERLY AND HAD A GROUNDING PAD ATTACHED FOR PROTECTION. NO OTHER PT COMPLICATIONS OCCURRED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KLEPPINGER BIPOLAR FORCEPS BIPOLAR FORCEPS HIN RICHARD WOLF MEDICAL INSTRUMENTS CORP. 8384.210 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other