BEUDAMED
    FDA Adverse Event Death Summary report: N

    UNK DEVICE

    MDR report key: 282826 · Received June 21, 2000

    Report

    Report Number
    1527736-2000-02715
    Event Type
    Death
    Date Received
    June 21, 2000
    Date of Event
    December 17, 1999
    Report Date
    May 30, 2000
    Manufacturer
    UNK
    Product Code
    GCJ
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    LA, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    RECEIVED SUBPOENA FROM ATTORNEY REPRESENTING A PHYSICIAN IN A MEDICAL MALPRACTICE ACTION. SUBPOENA STATES "AT ISSUE IN SAID ACTION IS SURGICAL TREATMENT PROVIDED AT MEDICAL CENTER TO THE PT BY DR., WHILE UTILIZING A TROCAR MFG BY ETHICON, INC. IT IS BELIEVED THAT A LOCKING MECHANISM OF THE TROCAR MAY HAVE MALFUNCTIONED DURING THE PROCEDURE." SUBPOENA DOES NOT SPECIFY A PRODUCT CODE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNK DEVICE UNK GCJ UNK NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Death