BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ETHICON ENDO-SURGERY, INC.

    MDR report key: 227590 · Received June 14, 1999

    Report

    Report Number
    MW1016532
    Event Type
    Malfunction
    Date Received
    June 14, 1999
    Date of Event
    December 19, 1998
    Report Date
    May 24, 1999
    Manufacturer
    ETHICON ENDO-SURGERY, INC.
    Product Code
    GAG
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    1 PROXIMATE RELOADABLE LINER STAPLER DID NOT FIRE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETHICON ENDO-SURGERY, INC. 1 PROXIMATE RELOADABLE LINEAR STAPLER GAG ETHICON ENDO-SURGERY, INC. 30MM CE 0123

    Patients

    Seq Age Sex Outcome Treatment
    1 84 YR