BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    5243521

    MDR report key: 5243521 · Received November 23, 2015

    Report

    Report Number
    5243521
    Event Type
    Malfunction
    Date Received
    November 23, 2015
    Date of Event
    January 9, 2015
    Report Date
    November 18, 2015
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    MI, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    GIA STAPLER USED DURING CASE AND STAPLER CLIPPED TOGETHER AND FIRED BUT DID NOT DISCARD ANY STAPLES OR LIGATE THE GI. NO HARM CAUSED TO THE PT. A NEW STAPLER WAS OPENED AND WORKED PROPERLY. STAPLER REF # (GIA6038S).

    Patients

    Seq Age Sex Outcome Treatment
    1 0 YR