BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LEHEY CLAMP

    MDR report key: 423936 · Received October 22, 2002

    Report

    Report Number
    MW1026497
    Event Type
    Injury
    Date Received
    October 22, 2002
    Date of Event
    September 5, 2002
    Report Date
    October 14, 2002
    Manufacturer
    PILLING CO
    Product Code
    GDJ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AZ, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    TIP OF CLAMP BROKE OFF WHILE PULLING OUT TISSUE. METAL PIECE WAS REMOVED THROUGH THE REGULAR COURSE OF THE SURGERY. NO ADVERSE EFFECTS. DEVICE WAS SENT OUT OF SVC AND MARKED AS "BROKEN" BY NURSING STAFF. DEVICE IS NOT AVAILABLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LEHEY CLAMP CLAMP GDJ PILLING CO 17-1155-353 T *

    Patients

    Seq Age Sex Outcome Treatment
    1 * Required Intervention