BEUDAMED
    FDA Adverse Event Other Summary report: N

    STRYKER ENDOSCOPY

    MDR report key: 748547 · Received July 20, 2005

    Report

    Report Number
    MW1036102
    Event Type
    Other
    Date Received
    July 20, 2005
    Date of Event
    July 18, 2005
    Report Date
    July 19, 2005
    Manufacturer
    STRYKER ENDOSCOPY
    Product Code
    KNS
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CO
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT IN FOR ENDOMETRIAL ABLATION. AT END OF CASE (AFTER PT HAD LEFT THE OR), STAFF NOTICED THAT THE LOOP AT THE END OF THE DEVICE WAS MISSING. PHYSICIAN WAS NOTIFIED & FOLLOW UP WILL BE DONE WITH THE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STRYKER ENDOSCOPY STRYKER 30 DEGREES CUTTING LOOP ELECTRODE - 24FR KNS STRYKER ENDOSCOPY * STRLC02

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR Other