BEUDAMED
    FDA Adverse Event Other Summary report: N

    HIGH TRANSMISSION AUTOCLAVABLE LIGHT CARRIER

    MDR report key: 82103 · Received March 6, 1997

    Report

    Report Number
    1519132-1997-90002
    Event Type
    Other
    Date Received
    March 6, 1997
    Date of Event
    March 4, 1997
    Report Date
    March 6, 1997
    Manufacturer
    CIRCON ACMI
    Product Code
    EQH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    KS, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT REPORTEDLY SUSTAINED SMALL BURN FROM LIGHT CORD AND LAPAROSCOPE BEING LEFT ON THE SURGICAL DRAPE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HIGH TRANSMISSION AUTOCLAVABLE LIGHT CARRIER LIGHT CARRIER EQH CIRCON ACMI G96 *

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO XENON HIGH INTENSITY LIGHT SOURCE| SNAP ON CONNECTOR FOR LIGHT CARRIER| SURGICAL DRAPE| CIRCON ACMI LAP10-OW USA SERIES LAPAROSCOPE SYSTEM