BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ETHICON

    MDR report key: 266861 · Received February 8, 2000

    Report

    Report Number
    266861
    Event Type
    Injury
    Date Received
    February 8, 2000
    Date of Event
    March 16, 1999
    Report Date
    April 2, 1999
    Manufacturer
    ETHICON ENDOSURGERY J/J CO
    Product Code
    GAG
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    PA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    SMALL PIECE OF PLASTIC DISLODGED INTO ABDOMEN. STAPLE LINE OPENED SPILLING FECAL MATERIAL INTO ABDOMINAL CAVITY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETHICON TIA GAG ETHICON ENDOSURGERY J/J CO * *

    Patients

    Seq Age Sex Outcome Treatment
    1 64 YR Required Intervention