BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VISISTAT 35R 6/BOX

    MDR report key: 4163207 · Received July 16, 2014

    Report

    Report Number
    3003898360-2014-00463
    Event Type
    Malfunction
    Date Received
    July 16, 2014
    Date of Event
    June 1, 2014
    Report Date
    June 20, 2014
    Manufacturer
    TELEFLEX
    Product Code
    GAG
    Report Source
    Manufacturer report
    Reporter Location
    FR
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    COMPLAINT ALLEGES: IT WAS REPORTED THAT THE STAPLER GETS BLOCKED. NO PT INJURY REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    416955 VISISTAT 35R 6/BOX STAPLER GAG TELEFLEX 01M1300167

    Patients

    Seq Age Sex Outcome Treatment
    1