FDA Adverse Event Injury Summary report: N

ENDO GIA ROTICULATOR 45-2.0 SULU

MDR report key: 2221615 · Received August 19, 2011

Report

Report Number
1219930-2011-00717
Event Type
Injury
Date Received
August 19, 2011
Date of Event
July 28, 2011
Report Date
July 28, 2011
Manufacturer
UNITED STATES SURGICAL
Product Code
GDW
PMA / PMN Number
K061095
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TW
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

PROCEDURE TYPE: SPLENECTOMY. ACCORDING TO THE REPORTER: THE PT WAS BLEEDING DUE TO NON-FORMATION OF STAPLES AFTER CUTTING DURING A SPLENECTOMY. MEDICAL INTERVENTION REQUIRED; SURGERY TIME WAS EXTENDED FOR MORE THAN 30 MINUTES; THE PT'S VITAL SIGNS ARE STABLE NOW.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDO GIA ROTICULATOR 45-2.0 SULU DISPOSABLE SURGICAL STAPLING DEVICE GDW UNITED STATES SURGICAL N7J233

Patients

Seq Age Sex Outcome Treatment
1 Other