BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LAPAROSCOPIC TISSUE SEALER G2 STRAIGHT JAW 5MM 45 CM

    MDR report key: 3221765 · Received July 8, 2013

    Report

    Report Number
    MW5030831
    Event Type
    Injury
    Date Received
    July 8, 2013
    Date of Event
    June 25, 2013
    Report Date
    July 2, 2013
    Manufacturer
    ETHICON ENDO-SURGERY ENSEAL
    Product Code
    GEI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MD, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    LAPAROSCOPIC TISSUE SEALER G2 STRAIGHT JAW 45 CM NOT CLOSING/OPERATING PROPERLY DURING THE PROCEDURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    309099 LAPAROSCOPIC TISSUE SEALER G2 STRAIGHT JAW 5MM 45 CM NONE GEI ETHICON ENDO-SURGERY ENSEAL REF NSLG2S45 K4C41U

    Patients

    Seq Age Sex Outcome Treatment
    1 71 YR Required Intervention