FDA Adverse Event Malfunction Summary report: N

WECK HEM-O-LOK ENDO APPLIER, ML

MDR report key: 2062440 · Received March 18, 2011

Report

Report Number
1044475-2011-00023
Event Type
Malfunction
Date Received
March 18, 2011
Report Date
February 23, 2011
Manufacturer
TELEFLEX MEDICAL
Product Code
FZP
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SD, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

PRODUCT IS NOT AVAILABLE FOR EVALUATION BY MANUFACTURER. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: THE SURGEON USED THE APPLIER DURING A PROCEDURE AND IT DID NOT ALLOW CLIP TO CLOSE AND LOCK PROPERLY. SURGEON REPORTED THAT THE APPLIERS FAILED TO ENGAGE THE CLIP CORRECTLY AND WOULD NOT LOCK ONTO THE STRUCTURE. NO PATIENT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 WECK HEM-O-LOK ENDO APPLIER, ML HEM-O-LOK ENDO APPLIER FZP TELEFLEX MEDICAL NA UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1