BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ETHICON ENDO-SURGERY INC.

    MDR report key: 378933 · Received February 20, 2002

    Report

    Report Number
    378933
    Event Type
    Malfunction
    Date Received
    February 20, 2002
    Date of Event
    February 1, 2002
    Report Date
    February 20, 2002
    Manufacturer
    ETHICON ENDOSURGERY
    Product Code
    GCJ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    ENDOPATH MULTISEAL CAP. THE INNER SEAL WAS FOUND IN THE ABDOMEN AND REMOVED LAPAROSCOPICALLY BY PHYSICIAN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETHICON ENDO-SURGERY INC. ENDOPATH MULTISEAL CAP REDUCTOUR GCJ ETHICON ENDOSURGERY A 92205P00 2006-09

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Other