BEUDAMED
    FDA Adverse Event Other Summary report: N

    PILLING

    MDR report key: 585723 · Received June 18, 2004

    Report

    Report Number
    MW4003890
    Event Type
    Other
    Date Received
    June 18, 2004
    Date of Event
    March 31, 2004
    Report Date
    May 11, 2004
    Manufacturer
    PILLING SURGICAL
    Product Code
    GCJ
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING LAPAROSCOPIC RADICAL PROSTATECTOMY WHEN FAN RETRACTOR WAS REMOVED STAFFF NOTICED A PIECE OF HING PIN MISSING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PILLING LAPAROSCOPIC FAN RETRACTOR GCJ PILLING SURGICAL * *

    Patients

    Seq Age Sex Outcome Treatment
    1 64 YR Other