FDA Adverse Event
Other
Summary report: N
LIMITED USE LAPCLINCH GRASPER TIP
MDR report key: 3012611
·
Received March 15, 2013
Report
- Report Number
- 1223422-2013-00005
- Event Type
- Other
- Date Received
- March 15, 2013
- Report Date
- March 15, 2013
- Manufacturer
- MICROLINE SURGICAL, INC.
- Product Code
- GEI
- PMA / PMN Number
- K974066
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NL
- Reporter Occupation
- NOT APPLICABLE
Narratives
Description of Event or Problem · 1
THE JAWS BROKE DURING SURGERY. NO ADDITIONAL PATIENT INFORMATION WAS PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 110518 | LIMITED USE LAPCLINCH GRASPER TIP | LAPCLINCH TIP | GEI | MICROLINE SURGICAL, INC. | 3251 | 00110018 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |