BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MULTIFEED STAPLER

    MDR report key: 14400 · Received June 29, 1994

    Report

    Report Number
    MW1002640
    Event Type
    Malfunction
    Date Received
    June 29, 1994
    Date of Event
    May 9, 1994
    Report Date
    May 27, 1994
    Manufacturer
    ETHICON ENDO-SURGERY
    Product Code
    GAG
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AZ, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    SURGEON STATED THAT EQUIPMENT WAS NOT FUNCTIONING CORRECTLY, REQUIRING THE USAGE OF SEVERAL OF EACH ITEM. (ALSO SEE 1002638, 1002639, 1002641, AND 1002642.)

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MULTIFEED STAPLER MULTIFEED STAPLER GAG ETHICON ENDO-SURGERY

    Patients

    Seq Age Sex Outcome Treatment
    1 76 YR