BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    LIGACLIP MCA MULTIPLE CLIP APPLIER - 23.8 CM, 20 MEDIUM

    MDR report key: 1810071 · Received November 13, 2007

    Report

    Report Number
    1527736-2007-07598
    Event Type
    Malfunction
    Date Received
    November 13, 2007
    Date of Event
    August 13, 2007
    Report Date
    October 24, 2007
    Manufacturer
    ETHICON ENDO-SURGERY, INC.
    Product Code
    GDO
    PMA / PMN Number
    K820837
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FR
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4): INFORMATION ANTICIPATED, BUT UNAVAILABLE AT THIS TIME.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT DURING A VASCULAR SURGERY, THE CLIPS WILL NOT HOLD. COMPLETED WITH THE SAME LIKE PRODUCT. THERE WAS NO PATIENT CONSEQUENCE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIGACLIP MCA MULTIPLE CLIP APPLIER - 23.8 CM, 20 MEDIUM GDO ETHICON ENDO-SURGERY, INC. NA D4H73L

    Patients

    Seq Age Sex Outcome Treatment
    1