BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    LIGAMAX 5 5 MM ENDOSCOPIC MULTIPLE CLIP APPLIER

    MDR report key: 2190789 · Received July 29, 2011

    Report

    Report Number
    MW5021581
    Event Type
    Malfunction
    Date Received
    July 29, 2011
    Date of Event
    July 28, 2011
    Report Date
    July 29, 2011
    Manufacturer
    ETHICON ENDO-SURGERY, LLC
    Product Code
    FZP
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    FL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    SURGEON WAS USING CLIP APPLIER DEVICE AND IT WORKED A FEW TIMES AND THEN STOPPED WORKING. NO HARM OR ADVERSE OUTCOME TO PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIGAMAX 5 5 MM ENDOSCOPIC MULTIPLE CLIP APPLIER MULTIPLE CLIP APPLIER FZP ETHICON ENDO-SURGERY, LLC REF EL5ML H4412C

    Patients

    Seq Age Sex Outcome Treatment
    1