MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2000-12-19 for STORZ * manufactured by Farl Storz-germany.
[215841]
Scope tip broke in 4 pieces; all retrieved from inside pt.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW1020655 |
| MDR Report Key | 309559 |
| Date Received | 2000-12-19 |
| Date of Report | 2000-12-19 |
| Date of Event | 2000-08-08 |
| Date Added to Maude | 2000-12-27 |
| Event Key | 0 |
| Report Source Code | Voluntary report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Reporter Occupation | RISK MANAGER |
| Health Professional | 3 |
| Initial Report to FDA | 0 |
| Report to FDA | 0 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | STORZ |
| Generic Name | PROSTATE SCOPE SET |
| Product Code | FGC |
| Date Received | 2000-12-19 |
| Model Number | * |
| Catalog Number | * |
| Lot Number | 100 |
| ID Number | 27040XB/XD,CEO12 3 LOT BK |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Implant Flag | Y |
| Date Removed | V |
| Device Sequence No | 1 |
| Device Event Key | 299505 |
| Manufacturer | FARL STORZ-GERMANY |
| Manufacturer Address | * * * |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2000-12-19 |