MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,user faci report with the FDA on 2017-04-13 for OPMI 1 MICROSCOPE ON S1 STAND manufactured by Carl Zeiss Meditec Ag (oberkochen).
[72807447]
Patient Sequence No: 1, Text Type: N, H10
[72807448]
This is case two of two reported from the same customer site. The health care professional (hcp) reported that, the site's technician was plugging the opmi 1 microscope on s1 stand into the power outlet. She received an electric shock when she accidently touched the exposed wire of the pre-damaged power cord (near the connector). The technician was not injured from the event. She did not consult a physician nor did she require any medical treatment.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9615010-2017-00004 |
| MDR Report Key | 6491369 |
| Report Source | HEALTH PROFESSIONAL,USER FACI |
| Date Received | 2017-04-13 |
| Date of Report | 2017-03-14 |
| Date of Event | 2017-03-06 |
| Date Mfgr Received | 2017-09-15 |
| Device Manufacturer Date | 1990-01-01 |
| Date Added to Maude | 2017-04-13 |
| 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 Contact | MR. WILLIAM GUSTAFSON |
| Manufacturer Street | CARL ZEISS MEDITEC, INC. |
| Manufacturer City | DUBLIN CA 94568 |
| Manufacturer Country | US |
| Manufacturer Postal | 94568 |
| Manufacturer Phone | 9255574689 |
| Manufacturer G1 | CARL ZEISS MEDITEC AG (OBERKOCHEN) |
| Manufacturer Street | RUDOLF-EBER-STRASSE 11 |
| Manufacturer City | OBERKOCHEN, BADEN-WUERTTEMBERG 73447 |
| Manufacturer Country | GM |
| Manufacturer Postal Code | 73447 |
| Single Use | 3 |
| Remedial Action | IN |
| Previous Use Code | 3 |
| Removal Correction Number | NA |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | OPMI 1 MICROSCOPE ON S1 STAND |
| Generic Name | SURGICAL MICROSCOPE |
| Product Code | FSO |
| Date Received | 2017-04-13 |
| Model Number | NA |
| Catalog Number | NA |
| Lot Number | NA |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | DA |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | CARL ZEISS MEDITEC AG (OBERKOCHEN) |
| Manufacturer Address | RUDOLF-EBER-STRASSE 11 OBERKOCHEN, BADEN-WUERTTEMBERG 73447 GM 73447 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2017-04-13 |