FDA Adverse Event Malfunction Summary report: N

LIGACLIP CLIP APPLIER

MDR report key: 3811447 · Received May 15, 2014

Report

Report Number
1527736-2014-00016
Event Type
Malfunction
Date Received
May 15, 2014
Report Date
April 17, 2014
Manufacturer
ETHICON ENDO SURGERY, INC (CINCINNATI)
Product Code
GDO
PMA / PMN Number
EXEMPT
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). INFORMATION WAS NOT PROVIDED BY THE CONTACT. DAMAGED JAWS THE ANALYSIS RESULTS CONFIRMED THAT THE LX207 DEVICE WAS RETURNED NON-FUNCTIONAL AS THE JAWS WERE MISALIGNED; THEREFORE, THE CLIPS COULD NOT BE LOADED INTO THE JAWS. NO CONCLUSION COULD BE REACHED AS TO WHAT MAY HAVE CAUSED THE FOUND CONDITION OF THE JAWS. IT SHOULD BE NOTED THAT AS PART OF OUR QUALITY PROCESS, EACH DEVICE IS VISUALLY INSPECTED AND FUNCTIONALLY TESTED DURING MANUFACTURING TO ENSURE THE DEVICE MEETS THE REQUIRED SPECIFICATIONS PRIOR TO SHIPMENT. EVENT COULD NOT BE CONFIRMED AS THE DEVICE OPENED AND CLOSED WITHOUT ANY DIFFICULTIES NOTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING UNKNOWN PROCEDURES, CLIPS SCISSORED, DEVICES DID NOT HOLD CLIPS, DEVICES WERE STICKING, AND JAWS DID NOT ALIGN. CASES WERE COMPLETED WITH NEW DEVICES OF SAME CODES. THERE WERE NO PATIENT CONSEQUENCES REPORTED. NO SPECIFIC PROCEDURE DATES OR PROCEDURE INFORMATION AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
290059 LIGACLIP CLIP APPLIER APPLIER, SURGICAL, CLIP GDO ETHICON ENDO SURGERY, INC (CINCINNATI) NA NA

Patients

Seq Age Sex Outcome Treatment
1