BEUDAMED
    FDA Adverse Event Other Summary report: N

    CLIP APPLIER CARTRIDGE

    MDR report key: 374785 · Received January 31, 2002

    Report

    Report Number
    2027111-2002-00006
    Event Type
    Other
    Date Received
    January 31, 2002
    Date of Event
    November 4, 2001
    Report Date
    January 31, 2002
    Manufacturer
    APPLIED MEDICAL RESOURCES
    Product Code
    GDO
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IT
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT CLIPS FROM THE CA040 CLIP APPLIER CARTRIDGE DID NOT COME TOGETHER AND FAILED TO HOLD ONTO CYSTIC DUCT. NO PATIENT COMPLICATION OR INJURY WAS REPORTED.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT CLIPS FROM THE CA040 CLIP APPLIER CARTRIDGE DID NOT COME TOGETHER AND FAILED TO HOLD ONTO CYSTIC DUCT. NO PT COMPLICATION OR INJURY WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CLIP APPLIER CARTRIDGE CLIP APPLIER GDO APPLIED MEDICAL RESOURCES CA040 E1G027

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention