FDA Adverse Event Malfunction Summary report: N

7383 GOMCO DELUXE 1.3

MDR report key: 1553885 · Received November 18, 2009

Report

Report Number
1282497-2009-00042
Event Type
Malfunction
Date Received
November 18, 2009
Date of Event
January 1, 2009
Report Date
November 13, 2009
Manufacturer
COVIDIEN
Product Code
FHG
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). AN INVESTIGATION IS CURRENTLY UNDERWAY. UPON COMPLETION, THE RESULTS WILL BE FORWARDED.

Description of Event or Problem · 1

IT WAS REPORTED TO COVIDIEN ON (B)(6) 2009, THAT A CUSTOMER HAD A PROBLEM WITH A GOMCO. THE CUSTOMER REPORTS THAT WHEN TIGHTENING THE CLAMP IT WOULD NOT THREAD ALL THE WAY DOWN PROVIDING A TIGHT SEAL, CREATING EXCESS BLEEDING. AS A RESULT, SURGICEL WAS APPLIED TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 7383 GOMCO DELUXE 1.3 GOMCO FHG COVIDIEN 52000033 UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK