BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LIGAMAX 5

    MDR report key: 1639110 · Received March 19, 2010

    Report

    Report Number
    MW5015247
    Event Type
    Injury
    Date Received
    March 19, 2010
    Date of Event
    March 8, 2010
    Report Date
    March 19, 2010
    Manufacturer
    CQ LABS
    Product Code
    GDO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MO, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING A LAPAROSCOPIC CHOLECYSTECTOMY, THE APPLIER BROKE. THE JAW WOULD NOT CLOSE AND IT WOULD NOT APPLY A CLIP PROPERLY. THIS OCCURRED AFTER CLIPPING VESSELS. THERE WAS NO PT INJURY AND THE CASE CONTINUED AS NORMAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIGAMAX 5 ENDOSCOPIC APPLIER GDO CQ LABS EL5ML GSR80L

    Patients

    Seq Age Sex Outcome Treatment
    1 37 YR Disability