BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    COVIDIEN PREMIUM SURGICLIP III

    MDR report key: 21422320 · Received February 20, 2025

    Report

    Report Number
    MW5166549
    Event Type
    Malfunction
    Date Received
    February 20, 2025
    Date of Event
    February 14, 2025
    Report Date
    February 15, 2025
    Manufacturer
    COVIDIEN
    Product Code
    FZP
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    RISK MANAGER
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    COVIDIEN PREMIUM SURGICLIP III REF 133650, LOT P280017. DEVICE FIRES BUT DOES NOT RELEASE CLIPS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1045759 COVIDIEN PREMIUM SURGICLIP III CLIP, IMPLANTABLE FZP COVIDIEN P280017

    Patients

    Seq Age Sex Outcome Treatment
    1 Male