FDA Adverse Event
Other
Summary report: N
CLIP APPLIER CARTRIDGE
MDR report key: 374789
·
Received January 31, 2002
Report
- Report Number
- 2027111-2002-00007
- Event Type
- Other
- Date Received
- January 31, 2002
- Report Date
- January 31, 2002
- Manufacturer
- APPLIED MEDICAL RESOURCES
- Product Code
- GDO
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NL
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
IT WAS REPORTED THAT ONE CLIP FROM THE CA040 CLIP APPLIER DIDN'T STAY AFTER PLACEMENT AND THE SECOND CLIP CUT THE VESSEL WHILE CLIPPING. NO FURTHER INFO COULD BE OBTAINED REGARDING THIS INCIDENT. NO PT INJURY OR COMPLICATION WAS REPORTED.
Description of Event or Problem · 1
IT WAS REPORTED THAT ONE CLIP FROM THE CA040 CLIP APPLIER DIDN'T STAY AFTER PLACEMENT AND THE SECOND CLIP CUT THE VESSEL WHILE CLIPPING. NO FURTHER INFORMATION COULD BE OBTAINED REGARDING THIS INCIDENT. NO PATIENT INJURY OR COMPLICATION WAS REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | CLIP APPLIER CARTRIDGE | CLIP APPLIER | GDO | APPLIED MEDICAL RESOURCES | CA040 | E1G029 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNKNOWN | Required Intervention |