BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    *

    MDR report key: 396763 · Received May 21, 2002

    Report

    Report Number
    1527736-2002-00973
    Event Type
    Malfunction
    Date Received
    May 21, 2002
    Date of Event
    April 4, 2002
    Report Date
    April 24, 2002
    Manufacturer
    ETHICON ENDO-SURGERY, INC.
    Product Code
    GAG
    Removal / Correction Number
    NA
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE DEVICE DID NOT FIRE STAPLES. USER FACILITY MEDWATCH #390133-2002-007.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * * GAG ETHICON ENDO-SURGERY, INC. NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other