*

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2008-03-22 for * manufactured by Karl Storz Imaging, Inc..

Event Text Entries

[8026968] Svc eval confirmed that middle button had come off the camera head; this is a material issue that the mfr is addressing with the supplier.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2027009-2008-00007
MDR Report Key1027743
Report Source06
Date Received2008-03-22
Device Manufacturer Date2007-12-01
Date Added to Maude2008-04-14
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag0
Reprocessed and Reused Flag0
Health Professional0
Initial Report to FDA0
Report to FDA3
Event Location0
Manufacturer Street175B CREMONA DR.
Manufacturer CityGOLETA CA 93117
Manufacturer CountryUS
Manufacturer Postal93117
Manufacturer Phone*
Manufacturer G1*
Manufacturer Street*
Manufacturer City*
Manufacturer Country*
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand Name*
Generic Name*
Product CodeFWG
Date Received2008-03-22
Model Number*
Catalog Number*
Lot Number*
ID Number*
Device Eval'ed by MfgrY
Implant FlagN
Device Sequence No1
Device Event Key994311
ManufacturerKARL STORZ IMAGING, INC.
Manufacturer Address175 CREMONA DR. GOLETA CA 93117 US


Patients

Patient NumberTreatmentOutcomeDate
10 2008-03-22

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