FDA Adverse Event Malfunction Summary report: N

LIGACLIP ENDOSCOPIC ROTATING MULTIPLE CLIP APPLIER 20 MEDIUM-LARGE TITANIUM LIGA

MDR report key: 1070654 · Received July 1, 2008

Report

Report Number
3005075853-2008-00247
Event Type
Malfunction
Date Received
July 1, 2008
Report Date
June 17, 2008
Manufacturer
ETHICON ENDO-SURGERY, LLC
Product Code
FZP
PMA / PMN Number
K864102
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AK, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INFORMATION ANTICIPATED, BUT UNAVAILABLE AT THIS TIME.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A LAPAROSCOPIC CHOLECYSTECTOMY PROCEDURE, THE DEVICE PRODUCED SCISSORED CLIPS. ANOTHER DEVICE WAS USED TO COMPLETE THE CASE. THERE WAS NO ADVERSE CONSEQUENCE TO THE PATIENT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LIGACLIP ENDOSCOPIC ROTATING MULTIPLE CLIP APPLIER 20 MEDIUM-LARGE TITANIUM LIGA FZP ETHICON ENDO-SURGERY, LLC NA UNK

Patients

Seq Age Sex Outcome Treatment
1