BEUDAMED
    FDA Adverse Event Injury Summary report: N

    COVIDIEN

    MDR report key: 2452310 · Received February 9, 2012

    Report

    Report Number
    MW5024228
    Event Type
    Injury
    Date Received
    February 9, 2012
    Report Date
    February 9, 2012
    Manufacturer
    US SURGICAL - COVIDIEN
    Product Code
    GDW
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MO, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PHYSICIAN WAS PERFORMING A LAPAROSCOPIC APPENDECTOMY. THE COVIDIEN ENDO GIA ULTRA UNIVERSAL STAPLER WAS NOT FIRING ALL STAPLES. FIRING WAS RANDOM. REMOVED WITHOUT DIFFICULTY. WAS USED WITH ENDO GIA CURVED TIP RELOAD WITH TRI-STAPLE TECHNOLOGY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 COVIDIEN GIA STAPLER GDW US SURGICAL - COVIDIEN EGIAUSTND N1L0413UKX

    Patients

    Seq Age Sex Outcome Treatment
    1 26 YR Disability