FDA Adverse Event Malfunction Summary report: N

WECK ENDO FASCIAL CLOSURE SYSTEM

MDR report key: 3217162 · Received July 5, 2013

Report

Report Number
1044475-2013-00092
Event Type
Malfunction
Date Received
July 5, 2013
Date of Event
June 20, 2013
Report Date
June 20, 2013
Manufacturer
TELEFLEX
Product Code
GCJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

SAMPLE HAS NOT BEEN RETURNED TO MFR IN TIME FOR THIS REPORT. NO LOT NUMBER IS AVAILABLE.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: ALLEGED ISSUE: THE TIP OF THE EFX NEEDLE BROKE WHILE THE DOCTOR WAS TRYING TO GET IT THROUGH THE PT'S ABDOMINAL WALL. THIS WAS DUE TO A LARGE AMOUNT OF DOWNWARD PRESSURE BEING APPLIED TO THE DEVICE WHICH CAUSE THE NEEDLE TO MISS THE SILICON PAD AND STRIKE THE OUTWARD WALL OF THE WINGS. NO REPORTED PT INJURY. PT CURRENT CONDITION IS FINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
307903 WECK ENDO FASCIAL CLOSURE SYSTEM FASCIAL CLOSURE SYSTEM GCJ TELEFLEX

Patients

Seq Age Sex Outcome Treatment
1