BEUDAMED
    FDA Adverse Event Injury Summary report: N

    COVIDIEN

    MDR report key: 2465609 · Received February 16, 2012

    Report

    Report Number
    MW5024302
    Event Type
    Injury
    Date Received
    February 16, 2012
    Date of Event
    September 19, 2011
    Report Date
    February 16, 2012
    Manufacturer
    US SURGICAL-COVIDIEN
    Product Code
    FZP
    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 CHOLECYSTECTOMY WITH INTRAOPERATIVE CHOLANGIOGRAMS. ACCORDING TO PHYSICIAN, ENDOSCOPIC CLIP APPLIER WOULD NOT WORK PROPERLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 COVIDIEN ENDO CLIP 5MM FZP US SURGICAL-COVIDIEN 176620 N0M0167

    Patients

    Seq Age Sex Outcome Treatment
    1 22 YR Disability