FDA Adverse Event Injury Summary report: N

TIGERPAW SYSTEM II

MDR report key: 4391892 · Received November 19, 2014

Report

Report Number
3008788191-2014-00021
Event Type
Injury
Date Received
November 19, 2014
Date of Event
November 27, 2013
Report Date
November 19, 2014
Manufacturer
LAAX INC
Product Code
GDW
PMA / PMN Number
K111064
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

LEFT ATRIAL APPENDAGE WAS TORN. PLEDGETED SUTURE WAS USED TO CONTROL BLEEDING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
751841 TIGERPAW SYSTEM II STAPLE, IMPLANTABLE GDW LAAX INC TP15AJ07 0972M

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention