BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    LIGACLIP MCA

    MDR report key: 2924635 · Received January 16, 2013

    Report

    Report Number
    2924635
    Event Type
    Malfunction
    Date Received
    January 16, 2013
    Date of Event
    December 28, 2012
    Report Date
    January 16, 2013
    Manufacturer
    ETHICON ENDO-SURGERY, INC
    Product Code
    FZP
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CO, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THE SMALL CLIP GUN WORKED THE FIRST TIME IT WAS USED THEN FAILED TO LOAD A CLIP FAR ENOUGH TO BE USED AGAIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    24150 LIGACLIP MCA CLIP, IMPLANTABLE FZP ETHICON ENDO-SURGERY, INC MCS20 J4CM1J

    Patients

    Seq Age Sex Outcome Treatment
    1 75 YR