FDA Adverse Event Malfunction Summary report: N

HOC PLUS ENDOTOUCH APPLIER 13" CVD

MDR report key: 2715209 · Received August 22, 2012

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Report

Report Number
1044475-2012-00110
Event Type
Malfunction
Date Received
August 22, 2012
Date of Event
July 12, 2012
Report Date
July 30, 2012
Manufacturer
TELEFLEX
Product Code
GDO
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
HR
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE SAMPLE WAS NOT RECEIVED BY THE MANUFACTURER AT THE TIME OF THIS REPORT.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: DURING LAPAROSCOPIC APPENDECTOMY, AFTER APPLYING FIRST CLIP WITH DIFFICULTY, SECOND CLIP COULDN'T BE APPLIED. INSTRUMENT IS VERY FREQUENTLY USED AND DUE TO NUMEROUS APPLICATIONS AND RE-STERILIZATIONS, JAWS BECAME LOOSE. NO PT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HOC PLUS ENDOTOUCH APPLIER 13" CVD ENDO APPLIER GDO TELEFLEX

Patients

Seq Age Sex Outcome Treatment
1