inforMED
MalfunctionFAS

ELECTRODE, UNIPOLAR, POINTED

Received Apr 14, 2025 · Event occurred Mar 18, 2025

Report 9610617-2025-00570 · MDR key 21834352

Device

Generic name

Electrode, Unipolar, Pointed

Model number

011111-10

Catalog number

011111-10

Lot number

850969

Product problems

  • Material Fragmentation
  • Material Fragmentation

Patient

NA · Unknown

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Description of Event or Problem

IT WAS REPORTED THAT "DURING THE PROCEDURE PART OF THE LOOP WAS DETACHED FROM ITS BODY." FURTHERMORE, IT WAS CONFIRMED THAT THE PROCEDURE WAS COMPLETED SUCCESSFULLY AND THERE WERE NO ADVERSE CONSEQUENCES FOR THE PATIENT. NO NEGATIVE IMPACT IN STATE OF HEALTH REPORTED.

Additional Manufacturer Narrative

THE AFFECTED DEVICE HAS BEEN REQUESTED FOR INVESTIGATION BY THE MANUFACTURER. DEVICE WAS NOT RETURNED AT THE TIME OF MDR SUBMISSION. THE EVENT IS FILED UNDER INTERNAL KARL STORZ COMPLAINT ID: (B)(4).

Additional Manufacturer Narrative

AN INCORRECT ADDRESS WAS PROVIDED IN SECTION G1 IN THE INITIAL REPORT. THIS SUPPLEMENTAL REPORT IS TO PROVIDE THE CORRECT CONTACT INFORMATION FOR THIS SECTION. THE EVENT IS FILED UNDER INTERNAL KARL STORZ COMPLAINT ID: (B)(4).