BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    COVIDIEN

    MDR report key: 1647156 · Received March 25, 2010

    Report

    Report Number
    MW5015316
    Event Type
    Malfunction
    Date Received
    March 25, 2010
    Date of Event
    March 25, 2010
    Report Date
    March 25, 2010
    Product Code
    GDO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    CLIP APPLIER FRACTURED ON THE TIP OF THE DEVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 COVIDIEN CLIP APPLIER GDO 176630

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR