inforMED
InjuryFBO

INNER SHEATH FOR 27050 SC

Received May 22, 2023 · Event occurred Jan 11, 2019

Report 9610617-2023-00642 · MDR key 16974012

Device

Generic name

Inner Sheath For 27050 Sc

Model number

27050CA

Catalog number

27050CA

Lot number

OW01

Product problems

  • Break
  • Break

Patient

Unknown

  • Insufficient Information
  • Insufficient Information

Narrative

Additional Manufacturer Narrative

BELATED EVALUATION AND REPORTING OF THIS COMPLAINT WAS DONE DURING RETROSPECTIVE REVIEW AS PART OF CAPA 20-0052 CORRECTIVE ACTION 6. THE AFFECTED PRODUCT HAS NOT BEEN RETURNED BECAUSE IT WAS SCRAPPED BY THE USER. THEREFORE NO DEVICE INVESTIGATION CAN BE PERFORMED. NO ROOT CAUSE CAN BE DETERMINED. A COMPLAINT ANALYSIS SHOWED THAT CASES WITH SIMILAR FAILURE DESCIRPTION WERE CAUSED BY MECHANICAL OVERLOAD OR MECHANICAL DAMAGE. THE EVENT IS FILED UNDER INTERNAL KARL STORZ COMPLAINT ID (B)(4).

Description of Event or Problem

IT WAS REPORTED THAT THE END OF THE SHEATH BROKE INSIDE THE PATIENT. OPERATION EXTENDED. USE OF ADDITIONAL ITEMS NOT REQUIRED TO REMOVE THE PART OF SHEATH.