BEUDAMED
    FDA Adverse Event Other Summary report: N

    ETHICON ENDO-SURGERY

    MDR report key: 2781846 · Received October 4, 2012

    Report

    Report Number
    MW5027182
    Event Type
    Other
    Date Received
    October 4, 2012
    Date of Event
    September 28, 2012
    Report Date
    September 28, 2012
    Manufacturer
    ETHICON ENDO-SURGERY
    Product Code
    LFL
    Report Source
    Voluntary report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    STARTED TO USE DEVICE, THEN CODE 5 APPEARED ON MACHINE. FOLLOWED INSTRUCTIONS, THEN HAD TO USE A SECOND DEVICE BECAUSE, THIS ONE DID NOT WORK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETHICON ENDO-SURGERY HARMONIC CURVED SHEARS 15MM ACTIVE BLADE LFL ETHICON ENDO-SURGERY 54AP3Y

    Patients

    Seq Age Sex Outcome Treatment
    1 51 YR