KARL STORZ 27069K

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 2009-06-04 for KARL STORZ 27069K manufactured by Karl Storz Gmbh & Co. Kg.

Event Text Entries

[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


MAUDE Entry Details

Report Number9610617-2009-00018
MDR Report Key1403474
Report Source06
Date Received2009-06-04
Date of Report2009-06-02
Date of Event2009-05-08
Date Facility Aware2009-05-13
Report Date2009-06-02
Date Reported to FDA2009-06-02
Date Reported to Mfgr2009-06-02
Date Added to Maude2010-03-26
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer StreetMITTELSTRASSE 8
Manufacturer CityTUTTLINGEN 78503
Manufacturer CountryGM
Manufacturer Postal78503
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameKARL STORZ
Generic NameCOLD KNIFE
Product CodeEZO
Date Received2009-06-04
Model Number27069K
Catalog Number27069K
Lot NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeNA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerKARL STORZ GMBH & CO. KG
Manufacturer AddressTUTTLINGEN GM


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2009-06-04

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