BEUDAMED
    FDA Adverse Event Other Summary report: N

    DISPOSABLE LAPCLINCH GRASPER TIP

    MDR report key: 3012631 · Received March 15, 2013

    Report

    Report Number
    1223422-2013-00004
    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 TIP SHEARED AT THE HINGE AND HAD TO BE RETRIEVED FROM THE ABDOMEN. THE EVENT DID NOT RESULT IN A SERIOUS INJURY. THE PATIENT IS FINE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    110890 DISPOSABLE LAPCLINCH GRASPER TIP LAPCLINCH TIP GEI MICROLINE SURGICAL INC. 3252 00108743

    Patients

    Seq Age Sex Outcome Treatment
    1