FDA Adverse Event Malfunction Summary report: N

WECK VISISTAT 35R 6/BOX

MDR report key: 3020998 · Received March 20, 2013

Report

Report Number
3003898360-2013-00111
Event Type
Malfunction
Date Received
March 20, 2013
Report Date
March 5, 2013
Manufacturer
TELEFLEX MEDICAL
Product Code
GDT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

SAMPLE NOT RETURNED TO MFR IN TIME FOR THIS REPORT.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: COMPLAINT DESCRIPTION - THE STAPLER STUCK, THEN IT SPIT OUT MORE THAN ONE AT A TIME. NO PT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
116081 WECK VISISTAT 35R 6/BOX SKIN STAPLER GDT TELEFLEX MEDICAL

Patients

Seq Age Sex Outcome Treatment
1