BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ETHICON ENDO-SURGERY

    MDR report key: 2023580 · Received March 14, 2011

    Report

    Report Number
    MW5019832
    Event Type
    Injury
    Date Received
    March 14, 2011
    Date of Event
    March 9, 2011
    Report Date
    March 14, 2011
    Product Code
    GDW
    Report Source
    Voluntary report
    Reporter Location
    MA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    STAPLER MISFIRED DURING USE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETHICON ENDO-SURGERY ENDOSCOPIC CURVED INTRALUMINAL STAPLER GDW H4340W

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR Disability