BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    COVIDIEN PR SURGICLIP APPLIER

    MDR report key: 17827578 · Received September 26, 2023

    Report

    Report Number
    MW5146209
    Event Type
    Malfunction
    Date Received
    September 26, 2023
    Date of Event
    August 1, 2023
    Report Date
    September 18, 2023
    Manufacturer
    COVIDIEN
    Product Code
    FZP
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    UNKNOWN
    Health Professional
    *

    Narratives

    Description of Event or Problem · 0

    COVIDIEN PREMIUM SURGICLIP III CLIP APPLIER. REF #133650. LOT# P2H0020. USE BY 2027-07-31. SURGICLIPS MISFIRED DURING SURGERY. REMOVED FROM THE FIELD AND REPLACED BY ANOTHER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    414612 COVIDIEN PR SURGICLIP APPLIER CLIP, IMPLANTABLE FZP COVIDIEN 133650 P2H0020

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown