BEUDAMED
    FDA Adverse Event Injury Summary report: N

    GRASPIT RETRIEVAL FORCEPS

    MDR report key: 687696 · Received March 16, 2006

    Report

    Report Number
    6000043-2006-00021
    Event Type
    Injury
    Date Received
    March 16, 2006
    Date of Event
    January 16, 2006
    Report Date
    February 14, 2006
    Manufacturer
    BOSTON SCIENTIFIC CORP.
    Product Code
    FFL
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    ME, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE TIP OF THIS STONE RETRIEVAL DEVICE DETACHED IN THE PATIENT DURING A THERAPEUTIC STONE RETRIEVAL PROCEDURE. THE DETACHED SEGMENT WAS RETRIEVED WITHOUT INCIDENT UTILIZING A SIMILAR DEVICE WHICH WAS USED TO SUCCESSFULLY COMPLETE THE PROCEDURE. NO PATIENT SEQUELLAE RESULTED FORM THIS EVENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 GRASPIT RETRIEVAL FORCEPS STONE RETRIEVAL FFL BOSTON SCIENTIFIC CORP. NA 7593678

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention