BEUDAMED
    FDA Adverse Event Other Summary report: N

    FILSHIE CLIP

    MDR report key: 1696440 · Received May 19, 2010

    Report

    Report Number
    MW5016005
    Event Type
    Other
    Date Received
    May 19, 2010
    Date of Event
    May 5, 2010
    Report Date
    May 6, 2010
    Manufacturer
    COOPER SURGICAL, INC.
    Product Code
    HGB
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    AT THE TIME OF SURGERY FOR HYSTERECTOMY, A FILSHIE CLIP WAS FOUND IN OMENTUM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FILSHIE CLIP FALLOPIAN TUBE OCCLUDER HGB COOPER SURGICAL, INC. 19064

    Patients

    Seq Age Sex Outcome Treatment
    1 29 YR