BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ENDOPATH VEIN HARVEST TRAY

    MDR report key: 38217 · Received September 13, 1996

    Report

    Report Number
    38217
    Event Type
    Injury
    Date Received
    September 13, 1996
    Date of Event
    August 16, 1996
    Report Date
    September 4, 1996
    Manufacturer
    ETHICON ENDO-SURGERY, INC.
    Product Code
    GCJ
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    RECEIVED MEDWATCH #05-0262-1996-0001 ON 8/29/96 "WHEN USING FEMORAL DISTAL GRAFT, DISSECTOR INSERTED AT GROIN TORE BRANCH OF SAPHENOUS VEIN."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ENDOPATH VEIN HARVEST TRAY VEIN HARVEST TRAY GCJ ETHICON ENDO-SURGERY, INC. NA NI

    Patients

    Seq Age Sex Outcome Treatment
    1 59 YR Required Intervention