BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LAPAROSCOPIC BOWEL GRASPER

    MDR report key: 6993475 · Received November 1, 2017

    Report

    Report Number
    MW5073065
    Event Type
    Injury
    Date Received
    November 1, 2017
    Date of Event
    October 28, 2017
    Report Date
    October 30, 2017
    Manufacturer
    KARL STORZ
    Product Code
    GCJ
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    PATIENT HAVING APPENDECTOMY. IN THE PROCESS OF TRYING TO GRASP THE APPENDIX, THE GRASPING DEVICE BROKE. THEN, A PERIOD OF TIME HAD TO BE UNDERTAKEN TO FIND THE PADDLE OF THE BROKEN GRASPER, WHICH WAS IDENTIFIED AND RETRIEVED IN ITS ENTIRETY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    774146 LAPAROSCOPIC BOWEL GRASPER GRASPER GCJ KARL STORZ 33121

    Patients

    Seq Age Sex Outcome Treatment
    1 19 YR