BEUDAMED
    FDA Adverse Event Other Summary report: N

    ETHICON ENDO-SURGERY INC.

    MDR report key: 556252 · Received November 19, 2004

    Report

    Report Number
    556252
    Event Type
    Other
    Date Received
    November 19, 2004
    Date of Event
    November 3, 2004
    Report Date
    November 17, 2004
    Manufacturer
    ETHICON ENDO-SURGERY INC
    Product Code
    LFL
    Report Source
    User Facility report
    Reporter Location
    NJ, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    HARMONIC DEVICE FAILED TO WORK. UPON EXAMINATION, THE TIP HAD FALLEN OFF ONTO THE FLOOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETHICON ENDO-SURGERY INC. ULTRACISION HARMONIC SCALPEL LFL ETHICON ENDO-SURGERY INC LCSC5 V42X1L

    Patients

    Seq Age Sex Outcome Treatment
    1 49 YR Other