BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ETHICON CLIP APPLIERS

    MDR report key: 204801 · Received December 30, 1998

    Report

    Report Number
    MW4002369
    Event Type
    Malfunction
    Date Received
    December 30, 1998
    Date of Event
    May 26, 1998
    Report Date
    September 16, 1998
    Manufacturer
    JOHNSON & JOHNSON
    Product Code
    GDO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    A 46 Y/O IN THE O.R. FOR LAPAROSCOPIC CHOLECYSTECTOMY. ENDOSCOPIC CLIP APPLIERS FAILED TO CLIP PROPERLY. NO ADVERSE OUTCOME TO PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETHICON CLIP APPLIERS * GDO JOHNSON & JOHNSON ER 420 *

    Patients

    Seq Age Sex Outcome Treatment
    1 46 YR Other