FDA Adverse Event Malfunction Summary report: N

ENDOPATH ENDOPATH REUSABLE CANNULA 5MM, 75MM LER

MDR report key: 402759 · Received June 28, 2002

Report

Report Number
1527736-2002-01247
Event Type
Malfunction
Date Received
June 28, 2002
Report Date
April 1, 2002
Manufacturer
ETHICON ENDO-SURGERY, INC.(TORRES)
Product Code
GCJ
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTEDLY THAT A DEVICE WAS USED DURING A LAP CHOLECYSTECTOMY. THE DEVICE BROKE IN HALF AND FELL INTO THE PT. THE SURGEON WAS ABLE TO RETRIEVE THE BROKEN PIECE. THE CASE WAS COMPLETED WITH ANOTHER DEVICE. THERE WERE NO CONSEQUENCES TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDOPATH ENDOPATH REUSABLE CANNULA 5MM, 75MM LER ENDOPATH RESPOSABLE TROCAR SYSTEM GCJ ETHICON ENDO-SURGERY, INC.(TORRES) NA NI

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other