inforMED
InjuryFBO

INNER SHEATH FOR 27050 SL

Received May 31, 2023 · Event occurred Jul 25, 2018

Report 9610617-2023-00651 · MDR key 17031024

Device

Generic name

Inner Sheath For 27050 Sl

Model number

27050XA

Catalog number

27050XA

Lot number

YS08

Product problems

  • Break
  • Break

Patient

Unknown

  • Insufficient Information
  • Insufficient Information

Narrative

Description of Event or Problem

IT WAS REPORTED THAT IT CAME TO A BREAKAGE OF THE INNER SHEATH. THE BROKEN PART WAS FORCED INTO THE PATIENT'S BLADDER BY THE FLUSHING AND HAD TO BE RECOVERED.

Additional Manufacturer Narrative

BELATED EVALUATION AND REPORTING OF THIS COMPLAINT WAS DONE DURING RETROSPECTIVE REVIEW AS PART OF CAPA 22-0074 CORRECTIVE ACTION 12. THE STEM HAS BEEN KINKED - ALL THE MILLED HOLES TOWARDS THE FLUSHING CONNECTION HAVE BEEN BROKEN THROUGH. THE CERAMIC BEAK IS BROKEN - THE BROKEN SURFACES ARE NOT DISCOLORED. VARIOUS NOTCHES CAN BE SEEN ON THE BAYONET. THE SHAFT WAS BENT BY FORCE. THE CERAMIC BEAK WAS ALSO DAMAGED. BASED ON THE SIGNS OF USE ON THE BAYONET, IT CAN BE ASSUMED THAT IT WAS USED FREQUENTLY. THE EVENT IS FILED UNDER INTERNAL KARL STORZ COMPLAINT ID (B)(4).