BEUDAMED
    FDA Adverse Event Summary report: N

    *

    MDR report key: 3073125 · Received April 17, 2013

    Report

    Report Number
    3073125
    Date Received
    April 17, 2013
    Date of Event
    April 2, 2013
    Report Date
    April 17, 2013
    Manufacturer
    ETHICON ENDO-SURGERY, INC.
    Product Code
    GDW
    Report Source
    User Facility report
    Reporter Location
    MA, US

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    166327 * STAPLE, IMPLANTABLE GDW ETHICON ENDO-SURGERY, INC. NTLC75 J4AZ6Z

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR