BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    WECK VISISTAT FIXED HEAD SKIN STAPLERS

    MDR report key: 2102966 · Received May 11, 2011

    Report

    Report Number
    3003898360-2011-00239
    Event Type
    Malfunction
    Date Received
    May 11, 2011
    Date of Event
    April 1, 2011
    Report Date
    April 18, 2011
    Manufacturer
    TELEFLEX MEDICAL
    Product Code
    GDW
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    SAMPLE RECEIVED BY MFR, BUT INVESTIGATION IS INCOMPLETE AT TIME OF THIS REPORT. A F/U REPORT WILL BE SENT WHEN INVESTIGATION IS COMPLETED.

    Description of Event or Problem · 1

    THE EVENT IS REPORTED AS: ALLEGED ISSUE: TWO OF THE STAPLERS JAMMED DURING A SPAY/NEUTER PROCEDURE. THE ANIMAL WAS NOT HARMED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 WECK VISISTAT FIXED HEAD SKIN STAPLERS SKIN STAPLER GDW TELEFLEX MEDICAL 01C1000227

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK