BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    UNKNOWN STAPLING DEVICE

    MDR report key: 11223577 · Received January 25, 2021

    Report

    Report Number
    1219930-2021-00353
    Event Type
    Malfunction
    Date Received
    January 25, 2021
    Report Date
    January 25, 2021
    Manufacturer
    COVIDIEN LP LLC NORTH HAVEN
    Product Code
    GDW
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    KS
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

    Description of Event or Problem · 1

    ACCORDING TO THE REPORTER, INTRA-OPERATIVELY, THE DEVICE ABLE TO BE "FIE" HOWEVER IT STOPPED HALFWAY AND PARTIALLY FIRED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    118343 UNKNOWN STAPLING DEVICE STAPLE, IMPLANTABLE GDW COVIDIEN LP LLC NORTH HAVEN UNKNOWN STAPLING DEVICE

    Patients

    Seq Age Sex Outcome Treatment
    1