BEUDAMED
    FDA Adverse Event Death Summary report: N

    ENDO GIA UNIVERSAL 12MM SINGLE USE INST

    MDR report key: 507699 · Received November 13, 2003

    Report

    Report Number
    1219930-2003-00260
    Event Type
    Death
    Date Received
    November 13, 2003
    Date of Event
    October 20, 2003
    Report Date
    October 23, 2003
    Manufacturer
    NORTH HAVEN - USS
    Product Code
    GAG
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    PHYSICIAN

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ENDO GIA UNIVERSAL 12MM SINGLE USE INST DISPOSABLE STAPLER GAG NORTH HAVEN - USS NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 * Death NUMBER UNKNOWN. EXPIRATION DATE UNKNOWN.| 030458 - ENDO GIA ROTICULATOR 60-3.5 SULU, LOT