FLEXOR G34879 FUS-107035

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-08-14 for FLEXOR G34879 FUS-107035 manufactured by Cook Incorporated.

Event Text Entries

[117017246] During ureteroscopy, the cook ureteral sheath frayed, leaving a shred of plastic in the urinary tract during ureteroscopy/ stone removal. Being that the shred was so small, several graspers did not work. The foreign body was finally removed prior to completion of procedure.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number7780282
MDR Report Key7780282
Date Received2018-08-14
Date of Report2018-07-19
Date of Event2018-05-29
Report Date2018-07-19
Date Reported to FDA2018-07-19
Date Reported to Mfgr2018-08-14
Date Added to Maude2018-08-14
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameFLEXOR
Generic NameDILATOR, URETHRAL
Product CodeKOE
Date Received2018-08-14
Model NumberG34879
Catalog NumberFUS-107035
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerCOOK INCORPORATED
Manufacturer Address750 DANIELS WAY BLOOMINGTON IN 47404 US 47404


Patients

Patient NumberTreatmentOutcomeDate
10 2018-08-14

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