BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ETHICON ENDO-SURGERY, INC.

    MDR report key: 284122 · Received June 30, 2000

    Report

    Report Number
    284122
    Event Type
    Injury
    Date Received
    June 30, 2000
    Date of Event
    May 19, 2000
    Report Date
    May 25, 2000
    Manufacturer
    ETHICON ENDO-SURGERY, INC.
    Product Code
    GCJ
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    OH, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT UNDERWENT DIAGNOSTIC LAPAROSCOPY. AT CONCLUSION OF PROCEDURE PT BECAME TACHYCARDIC, HYPOXIC, WITH ABDOMINAL DISTENTION. EMERGENT LAPAROTOMY DONE WITH REPAIR OF ILIAC ARTERY AT BIFURCATION OF AORTA.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETHICON ENDO-SURGERY, INC. BLUNT TIP TROCAR WITH RADIOLUCENT SLEEVE GCJ ETHICON ENDO-SURGERY, INC. 512B *

    Patients

    Seq Age Sex Outcome Treatment
    1 37 YR Hospitalization| L| R