MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2008-06-12 for KOH CUP KCP-30 manufactured by Coopersurgical, Inc..
[872456]
A lavh was started, but aborted. The koh cup was left in the pt. The pt complained of a vaginal discharge, but no pain. The pt returned to the ob/gyn who performed an external exam. The pt eventually returned to the primary physician who performed an internal exam removing the koh cup. The pt was treated with a vaginal wash and prescribed antibiotics. The procedure has been reported to have occurred in 2007.
Patient Sequence No: 1, Text Type: D, B5
[8006177]
In keeping with good medical practice, it is the responsibility of the physician to ensure all non-implantable devices are removed from the pt.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 1216677-2008-00018 |
| MDR Report Key | 1059861 |
| Report Source | 06 |
| Date Received | 2008-06-12 |
| Date of Report | 2008-06-09 |
| Date Mfgr Received | 2008-05-12 |
| Date Added to Maude | 2009-09-24 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | THOMAS WILLIAMS |
| Manufacturer Street | 95 CORPORATE DR. |
| Manufacturer City | TRUMBULL CT 06611 |
| Manufacturer Country | US |
| Manufacturer Postal | 06611 |
| Manufacturer Phone | 2036015200 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | KOH CUP |
| Generic Name | COLPOTOMIZER SYSTEM |
| Product Code | HDM |
| Date Received | 2008-06-12 |
| Model Number | KCP-30 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | COOPERSURGICAL, INC. |
| Manufacturer Address | TRUMBULL CT US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2008-06-12 |