BEUDAMED
    FDA Adverse Event Other Summary report: N

    STRYKER 3MM GRASPER

    MDR report key: 842970 · Received April 23, 2007

    Report

    Report Number
    MW1042696
    Event Type
    Other
    Date Received
    April 23, 2007
    Date of Event
    April 4, 2007
    Report Date
    April 23, 2007
    Manufacturer
    STRYKER ENDOSCOPY
    Product Code
    HTD
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    KY, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    GRASPER GRASPING END BROKE OFF DURING REMOVAL OF APPENDIX THROUGH A TROCAR. RIVOT HAD SEPARATED FROM THE ONE GRASPER HINGE POINT. MAY HAVE BEEN DUE TO PRESSURE APPLIED. NO DIRECT PATIENT HARM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STRYKER 3MM GRASPER STRYKER GRASPER HTD STRYKER ENDOSCOPY * 0440791

    Patients

    Seq Age Sex Outcome Treatment
    1 14 YR Other