STORZ E-4210 *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2001-05-02 for STORZ E-4210 * manufactured by Storz Instrument Co.

Event Text Entries

[188921] Tip of bowman lachrymal probe, size o, missing after nasal-lacrimal duct probe, left eye. Retained foreign body in lacrimal duct confirmed by x-ray and ct.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number330371
MDR Report Key330371
Date Received2001-05-02
Date of Report2001-04-27
Date of Event2001-04-19
Date Facility Aware2001-04-20
Report Date2001-04-27
Date Reported to FDA2001-05-01
Date Reported to Mfgr2001-05-01
Date Added to Maude2001-05-08
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameSTORZ
Generic NameBOWMAN LACHRYMAL PROBE
Product CodeHNL
Date Received2001-05-02
Model NumberE-4210
Catalog Number*
Lot Number*
ID Number*
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Age5 YR
Implant FlagN
Date RemovedA
Device Sequence No1
Device Event Key319731
ManufacturerSTORZ INSTRUMENT CO
Manufacturer Address3365 TREE COURT INDUST. BLVD ST LOUIS MO 631226694 US
Baseline Brand NameSTORZ
Baseline Generic NameBOWMAN LACHRYMAL PROBE
Baseline Model NoE-4210
Baseline Catalog No*
Baseline ID*


Patients

Patient NumberTreatmentOutcomeDate
10 2001-05-02

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