BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ENDOPOUCH RETRIEVER

    MDR report key: 1789277 · Received August 4, 2010

    Report

    Report Number
    MW5016986
    Event Type
    Malfunction
    Date Received
    August 4, 2010
    Date of Event
    January 9, 2010
    Report Date
    July 30, 2010
    Manufacturer
    ETHICON ENDOSURGERY / J+J
    Product Code
    MDM
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NY, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    ENDOBAG BROKE IN PATIENT'S ABDOMEN WHEN SURGEON WAS TRYING TO RETRIEVE A SPECIMEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ENDOPOUCH RETRIEVER ENDOPOUCH RETRIEVER MDM ETHICON ENDOSURGERY / J+J F4PV26

    Patients

    Seq Age Sex Outcome Treatment
    1