BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PREMIUM SURGICLIP II M - 11.5

    MDR report key: 2081815 · Received May 3, 2011

    Report

    Report Number
    MW5020495
    Event Type
    Malfunction
    Date Received
    May 3, 2011
    Date of Event
    May 2, 2011
    Report Date
    May 2, 2011
    Manufacturer
    AUTOSUTURE
    Product Code
    FZP
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    SURGICAL CLIP UNABLE TO FIRE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PREMIUM SURGICLIP II M - 11.5 NONE FZP AUTOSUTURE PIA0788

    Patients

    Seq Age Sex Outcome Treatment
    1