FDA Adverse Event Injury Summary report: N

CONTOUR CURVED CUTTER STAPLER

MDR report key: 1053132 · Received May 8, 2008

Report

Report Number
1527736-2008-02844
Event Type
Injury
Date Received
May 8, 2008
Date of Event
April 8, 2008
Report Date
April 15, 2008
Manufacturer
ETHICON ENDO SURGERY, INC. (CINCINNATI)
Product Code
GAG
PMA / PMN Number
K040038
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INFO IS UNAVAILABLE; DEVICE WAS NOT RETURNED FOR EVAL.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A LOW ANTERIOR RESECTION, THE DEVICE STAPLED THE PROXIMAL LINE AND PRODUCED A CUT LINE, BUT FAILED TO STAPLE THE DISTAL LINE. SURGERY WAS PROLONGED 240 MINUTES AS THE SURGEON HAD TO HAND STITCH THE DISTAL LINE TRANSANALLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CONTOUR CURVED CUTTER STAPLER GAG ETHICON ENDO SURGERY, INC. (CINCINNATI) NA D4J071

Patients

Seq Age Sex Outcome Treatment
1 Other