BEUDAMED
    FDA Adverse Event Other Summary report: N

    AUTO SUTURE

    MDR report key: 1790457 · Received August 4, 2010

    Report

    Report Number
    MW5017011
    Event Type
    Other
    Date Received
    August 4, 2010
    Date of Event
    June 29, 2010
    Report Date
    June 30, 2010
    Manufacturer
    TYCO HEALTHCARE GROUP, UNITED STATES SURGICAL
    Product Code
    GDW
    Report Source
    Voluntary report
    Reporter Location
    GA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PRODUCT USED THROUGH LAPAROSCOPIC PORT ¿ BEFORE FIRING STAPLES FELL OUT INTO FIELD ALONG WITH BLADE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AUTO SUTURE ENDO GIA UNIVERSAL STRAIGHT 45-2.0 GDW TYCO HEALTHCARE GROUP, UNITED STATES SURGICAL 030426 POD0032

    Patients

    Seq Age Sex Outcome Treatment
    1