BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    JAKO-KLEINSASSER MICRO-LARYNGEAL SCISSORS

    MDR report key: 613756 · Received July 12, 2004

    Report

    Report Number
    2515651-2004-00004
    Event Type
    Malfunction
    Date Received
    July 12, 2004
    Report Date
    June 11, 2004
    Manufacturer
    *
    Product Code
    KBM
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    A SMALL PIECE OF THE SCISSOR'S BLADE DETACHED FROM THE INSTRUMENT DURING A MICRO DIRECT LARYNGOSCOPY PROCEDURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 JAKO-KLEINSASSER MICRO-LARYNGEAL SCISSORS MICRO-LARYNGEAL SCISSORS KBM * * UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other