MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2001-05-22 for * manufactured by Storz Instrument Company.
[222330]
Tip of bowman lachrymal probe, size 0, 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
| Report Number | 1932180-2001-00002 |
| MDR Report Key | 334287 |
| Report Source | 06 |
| Date Received | 2001-05-22 |
| Date of Event | 2001-04-19 |
| Date Mfgr Received | 2001-04-26 |
| Date Added to Maude | 2001-05-24 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 0 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 0 |
| Initial Report to FDA | 0 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | JULI MOORE |
| Manufacturer Street | 3365 TREECOURT INDUST. BLVD |
| Manufacturer City | ST. LOUIS MO 63122 |
| Manufacturer Country | US |
| Manufacturer Postal | 63122 |
| Manufacturer Phone | 6362263220 |
| Manufacturer G1 | * |
| Manufacturer Street | * |
| Manufacturer City | * |
| Manufacturer Country | * |
| Single Use | 3 |
| Previous Use Code | 3 |
| Removal Correction Number | NA |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | * |
| Product Code | HNL |
| Date Received | 2001-05-22 |
| Device Eval'ed by Mfgr | R |
| Implant Flag | N |
| Date Removed | B |
| Device Sequence No | 1 |
| Device Event Key | 319731 |
| Manufacturer | STORZ INSTRUMENT COMPANY |
| Manufacturer Address | 3365 TREECOURT INDUST. BLVD ST. LOUIS MO 631226694 US |
| Baseline Brand Name | STORZ |
| Baseline Generic Name | BOWMAN LACHRYMAL PROBE |
| Baseline Model No | E-4210 |
| Baseline Catalog No | * |
| Baseline ID | * |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2001-05-22 |