FDA Adverse Event Malfunction Summary report: N

ENDO CATCH II 15MM SPECIMEN POUCH

MDR report key: 1019139 · Received March 24, 2008

Report

Report Number
9612501-2008-00017
Event Type
Malfunction
Date Received
March 24, 2008
Report Date
February 25, 2008
Manufacturer
SANTO DOMINGO - USS
Product Code
GCJ
PMA / PMN Number
K922123
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INITIAL REPORT SUBMITTED: MARCH 21, 2008.

Description of Event or Problem · 1

PROCEDURE: UNK. ACCORDING TO THE REPORTER: THE ENDOCATCH II BAG TORE DURING THE UNFOLDING. THERE WAS NO FURTHER REPORT OF PATIENT INJURY. THE SPECIMEN WAS MANUALLY REMOVED FROM THE PATIENT CAVITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDO CATCH II 15MM SPECIMEN POUCH SURGICAL HAND INSTRUMENT GCJ SANTO DOMINGO - USS J6H02

Patients

Seq Age Sex Outcome Treatment
1 UNK