FDA Adverse Event Summary report: N

RELOADER STAPLER UNIT

MDR report key: 4493 · Received July 2, 1992

Report

Report Number
4493
Date Received
July 2, 1992
Manufacturer
ETHICON, INC.
Product Code
GAG
Report Source
User Facility report

Narratives

Description of Event or Problem · 1

ON MAY 15, 1992, A PATIENT UNDERWENT A COLECTOMY. A PROXIMATE LINEAR CUTTER WAS USED INITIALLY WITHOUT INCIDENT. A RELOADER UNIT WAS THEN USED. THIS UNIT DID NOT EXPEL ALL THE STAPLES. APPROXIMATELY 50% OF THE STAPLES WERE EXPELLED. THIS WAS DISCOVERED IMMEDIATELY. THERE WAS SOME FECAL CONTAMINATION OF THE SURGICAL FIELD AS A RESULT OF THIS EQUIPMENT MALFUNCTION. THIS WAS IMMEDIATELY CONTAINED AND THE PELVIS WAS IRRIGATED. THE BOWEL WAS CLOSED WITHOUT FURTHER INCIDENT.THE PATIENT HAD NO COMPLICATIONS FROM THIS INCIDENT.INVALID DATA - REGARDING SINGLE USE LABELING OF DEVICE. PATIENT MEDICAL STATUS PRIOR TO EVENT: INVALID DATA. INVALID DATA - REGARDING MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY. INVALID DATA - REGARDING WHETHER EVENT PRESENTS IMMINENT HAZARD. INVALID DATA - WHETHER DEVICE USED AS LABELED/INTENDED. INVALID DATA - REGARDING EVALUATION BY USER AFTER EVENT. METHOD OF EVALUATION: INVALID DATA. RESULTS OF EVALUATION: INVALID DATA. CONCLUSION: INVALID DATA. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: INVALID DATA. CORRECTIVE ACTIONS: NO DATA. INVALID DATA - ON DEVICE DESTROYED/DISPOSED OF STATUS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RELOADER STAPLER UNIT GAG ETHICON, INC. CL-14LH

Patients

Seq Age Sex Outcome Treatment
1 Invalid Data