BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ETHICON ENDO-SURGERY, INC - REPROCESSED BY STRYKER

    MDR report key: 2824721 · Received November 2, 2012

    Report

    Report Number
    MW5027529
    Event Type
    Malfunction
    Date Received
    November 2, 2012
    Date of Event
    October 24, 2012
    Report Date
    November 2, 2012
    Manufacturer
    STRYKER SUSTAINAILITY SOLUTIONS
    Product Code
    LFL
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    SC, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING LAPAROSCOPIC CASE, HARMONIC SCALPEL TEFLON TIP FELL OFF. TIP RETRIEVED. SENT TO COMPANY FOR FOLLOW UP. DIAGNOSIS OR REASON FOR USE: LYSIS OF ADHESIONS, R SALPINGOOPHORECTOMY, L PARTIAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETHICON ENDO-SURGERY, INC - REPROCESSED BY STRYKER HARMONIC SCALPEL LFL STRYKER SUSTAINAILITY SOLUTIONS ACE36E 2150837

    Patients

    Seq Age Sex Outcome Treatment
    1 39 YR