BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LIGAMAX 5 MM

    MDR report key: 2982679 · Received February 21, 2013

    Report

    Report Number
    MW5029138
    Event Type
    Injury
    Date Received
    February 21, 2013
    Date of Event
    February 21, 2013
    Report Date
    February 21, 2013
    Manufacturer
    ETHICON ENDO-SURGERY LLC
    Product Code
    FZP
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    LIGAMAX 5 ENDOSCOPIC CLIP APPLIER NOT FULLY CLOSING ENDOSCOPIC CLIPS. DIAGNOSIS OR REASON FOR USE: ENDOSCOPIC THORACIC SURGERY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    76272 LIGAMAX 5 MM 5 MM ENDOSCOPIC MULTIPLE CLIP APPLIER FZP ETHICON ENDO-SURGERY LLC EL5ML H44U90

    Patients

    Seq Age Sex Outcome Treatment
    1 62 YR Required Intervention