FDA Adverse Event
Malfunction
Summary report: N
AUTO SUTURE MULTIFIRE GIA 60-3.8
MDR report key: 122456
·
Received September 23, 1997
Report
- Report Number
- 2647580-1997-01152
- Event Type
- Malfunction
- Date Received
- September 23, 1997
- Date of Event
- August 26, 1997
- Report Date
- August 27, 1997
- Manufacturer
- UNITED STATES SURGICAL CORPORATION
- Product Code
- GAG
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AS
- Reporter Occupation
- NURSE
Narratives
Additional Manufacturer Narrative · 1
12/03/1997-SUPPLEMENTAL REPORT #1 SUBMITTED TO FDA.
Description of Event or Problem · 1
THE DEVICE WAS USED DURING A BOWEL RESECTION PROCEDURE. REPORTEDLY, THE INSTRUMENT MISFIRED. THE SURGEON APPLIED ANOTHER INSTRUMENT TO COMPLETE THE PROCEDURE. THE HOSPITAL HAS REPORTED NO PT INJURY OCCURRED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | AUTO SUTURE MULTIFIRE GIA 60-3.8 | DISPOSABLE SURGICAL STAPLER | GAG | UNITED STATES SURGICAL CORPORATION | NA | P7F220 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNKNOWN |