BEUDAMED
    FDA Adverse Event Other Summary report: N

    UROLOGICAL GRASPING FORCEPS

    MDR report key: 836777 · Received April 5, 2007

    Report

    Report Number
    MW1042504
    Event Type
    Other
    Date Received
    April 5, 2007
    Date of Event
    January 10, 2007
    Report Date
    April 5, 2007
    Manufacturer
    BOSTON SCIENTIFIC
    Product Code
    GEN
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    VT, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING URETEROSCOPY FOR CALCULI, DURING BASKETING, THE TIP OF THE GRASPING FORCEPS BROKE OFF IN THE UPPER URETER - I/JUNCTION OF THE KIDNEY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UROLOGICAL GRASPING FORCEPS GRASPIT GEN BOSTON SCIENTIFIC * 9245463

    Patients

    Seq Age Sex Outcome Treatment
    1 28 YR Other