BEUDAMED
    FDA Adverse Event Injury Summary report: N

    *

    MDR report key: 316090 · Received February 12, 2001

    Report

    Report Number
    MW1021067
    Event Type
    Injury
    Date Received
    February 12, 2001
    Date of Event
    January 30, 2001
    Report Date
    February 12, 2001
    Manufacturer
    VANGUARD
    Product Code
    GCJ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NY, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    LAPAROSCOPIC REMOVAL OF BOTH OVARIES AND TUBES. DURING CASE A VANGUARD, JCN-283107 REPROCESSED ENDOCATH MADE BY AUTOSUTURE, CAT# 173050, SEPARATED INSIDE ABDOMEN. DR WAS ABLE TO RETRIEVE DEVICE IN TOTAL. IF DR WAS UNABLE TO RETRIEVE, A LAPAROTOMY WOULD HAVE BEEN PERFORMED. PT FINE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    5315 * ENDOCATCH GCJ VANGUARD * 173050

    Patients

    Seq Age Sex Outcome Treatment
    1 * Required Intervention