BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ETHICON

    MDR report key: 1052144 · Received May 23, 2008

    Report

    Report Number
    MW5007023
    Event Type
    Injury
    Date Received
    May 23, 2008
    Date of Event
    April 9, 2008
    Report Date
    May 23, 2008
    Manufacturer
    ETHICON ENDO-SURGERY
    Product Code
    GCJ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PHYSICIAN ADVANCED INSTRUMENT THEN IT LOCKED. HE TOOK OUT THE STAPLES, CUT THE BOWEL AND USED ANOTHER INSTRUMENT TO FINISH SURGERY. NO HARM TO PT. DATES OF USE: 2008. DIAGNOSIS OR REASON FOR USE: SURGERY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETHICON LINEAR CUTTER W/SAFETY LOCK-OUT GCJ ETHICON ENDO-SURGERY REF# TLC75 E4K85C

    Patients

    Seq Age Sex Outcome Treatment
    1 Disability