BEUDAMED
    FDA Adverse Event Other Summary report: N

    ENDO GIA ULTRA UNIVERSAL STAPLER

    MDR report key: 3010706 · Received March 12, 2013

    Report

    Report Number
    MW5029378
    Event Type
    Other
    Date Received
    March 12, 2013
    Date of Event
    March 4, 2013
    Report Date
    March 4, 2013
    Manufacturer
    COVIDIEN
    Product Code
    GDW
    Report Source
    Voluntary report
    Reporter Location
    AK, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    WAS POSITIONED ON BOWEL, BUT DID NOT FIRE. DR (B)(6).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    104439 ENDO GIA ULTRA UNIVERSAL STAPLER ENDO GIA GDW COVIDIEN EGIA USTND N2J0538UMX

    Patients

    Seq Age Sex Outcome Treatment
    1 24 YR