BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ETHICON 10MM LIGACLIP

    MDR report key: 3040026 · Received April 2, 2013

    Report

    Report Number
    MW5029611
    Event Type
    Injury
    Date Received
    April 2, 2013
    Date of Event
    February 26, 2013
    Report Date
    March 21, 2013
    Manufacturer
    ETHICON - ENDO SURGERY INC.
    Product Code
    FZP
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MD, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    A 5MM LAPAROSCOPIC CLIP APPLIER WAS BEING USED FOR A LAPAROSCOPIC CHOLECYSTECTOMY. CLIP APPLIER FIRED; CLIP WAS TOO LOOSE TO SEAL VESSEL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    134906 ETHICON 10MM LIGACLIP LIGACLIP FZP ETHICON - ENDO SURGERY INC. J4CV48

    Patients

    Seq Age Sex Outcome Treatment
    1 46 YR Required Intervention