BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ETHICON ENDO SURGERY, INC

    MDR report key: 332462 · Received May 3, 2001

    Report

    Report Number
    332462
    Event Type
    Injury
    Date Received
    May 3, 2001
    Date of Event
    March 6, 2001
    Report Date
    March 28, 2001
    Manufacturer
    ETHICON ENDOSURGERY, INC.
    Product Code
    GDO
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    OH, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    CLIP APPLIER MISFIRING DURING PROCEDURE, NOT APPLYING CLIPS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    20840 ETHICON ENDO SURGERY, INC ENDOSCOPIC ROTATING CLIP APPLIER GDO ETHICON ENDOSURGERY, INC. P30044P05 M4FU27

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR Hospitalization