MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2009-06-04 for KARL STORZ 27069K manufactured by Karl Storz Gmbh & Co. Kg.
[15161993]
The doctor was performing an optical urethrotomy when the tip of the cold knife broke off. Xray confirmed it was positioned next to a catheter in the peno-scrotal junction. Doctor did not want to remove catheter which was difficult to place, so he left the tip of the knife in patient and completed procedure. He waited a week for swelling to go down and then removed the knife tip and the catheter at the same time. Patient condition was reported as good.
Patient Sequence No: 1, Text Type: D, B5
[15452827]
Although the subject instrument was not returned, hospital reported that knife broke on a very hard membraneous mid-prostatic rock hard urethral stricture. Damage most likely due to mechanical overload.
Patient Sequence No: 1, Text Type: N, H10
Report Number | 9610617-2009-00018 |
MDR Report Key | 1403474 |
Report Source | 06 |
Date Received | 2009-06-04 |
Date of Report | 2009-06-02 |
Date of Event | 2009-05-08 |
Date Facility Aware | 2009-05-13 |
Report Date | 2009-06-02 |
Date Reported to FDA | 2009-06-02 |
Date Reported to Mfgr | 2009-06-02 |
Date Added to Maude | 2010-03-26 |
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 | 3 |
Event Location | 3 |
Manufacturer Street | MITTELSTRASSE 8 |
Manufacturer City | TUTTLINGEN 78503 |
Manufacturer Country | GM |
Manufacturer Postal | 78503 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | KARL STORZ |
Generic Name | COLD KNIFE |
Product Code | EZO |
Date Received | 2009-06-04 |
Model Number | 27069K |
Catalog Number | 27069K |
Lot Number | UNK |
Operator | HEALTH PROFESSIONAL |
Device Availability | N |
Device Age | NA |
Device Eval'ed by Mfgr | R |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | KARL STORZ GMBH & CO. KG |
Manufacturer Address | TUTTLINGEN GM |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Other | 2009-06-04 |