BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ETHICON

    MDR report key: 1698622 · Received May 20, 2010

    Report

    Report Number
    MW5016050
    Event Type
    Injury
    Date Received
    May 20, 2010
    Date of Event
    May 7, 2010
    Report Date
    May 20, 2010
    Manufacturer
    CQ LABS
    Product Code
    LFL
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MO, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING A GASTRIC BANDING LAPAROSCOPIC SURGERY, REPROCESSED HARMONIC ACE SHEARS STOPPED WORKING IN THE MIDDLE OF THE SURGERY. NEW HARMONIC SHEARS WERE OPENED AND USED TO COMPLETE THE SURGERY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETHICON HARMONIC ACE SHEARS LFL CQ LABS ACE36E 1008987

    Patients

    Seq Age Sex Outcome Treatment
    1 39 YR Disability