FDA Adverse Event Malfunction Summary report: N

ECHELON 60 ENDOPATH STAPLER

MDR report key: 1080333 · Received July 24, 2008

Report

Report Number
1527736-2008-00292
Event Type
Malfunction
Date Received
July 24, 2008
Date of Event
November 13, 2007
Report Date
June 27, 2008
Manufacturer
ETHICON ENDO-SURGERY, LLC
Product Code
GDW
PMA / PMN Number
K051002
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DATE SENT: 07/08/2008. INFO ANTICIPATED, BUT UNAVAILABLE AT THIS TIME.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A LAP SPLENECTOMY PROCEDURE, THE DEVICE FAILED TO OPEN AFTER CLOSURE OF THE JAWS. ANOTHER DEVICE WAS USED TO COMPLETE THE CASE. THERE WAS NO ADVERSE CONSEQUENCES TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ECHELON 60 ENDOPATH STAPLER NONE GDW ETHICON ENDO-SURGERY, LLC NA D4J225

Patients

Seq Age Sex Outcome Treatment
1