BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    COVIDIEN SILS STITCH 10MM

    MDR report key: 2182319 · Received July 22, 2011

    Report

    Report Number
    MW5021509
    Event Type
    Malfunction
    Date Received
    July 22, 2011
    Date of Event
    July 20, 2011
    Report Date
    July 22, 2011
    Manufacturer
    TYCO HEALTHCARE
    Product Code
    OCW
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    MALFUNCTIONED BY DROPPING SWITCH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 COVIDIEN SILS STITCH 10MM COVIDIEN SILS STITCH 10MM OCW TYCO HEALTHCARE N0G0604U

    Patients

    Seq Age Sex Outcome Treatment
    1 35 YR