BEUDAMED
    FDA Adverse Event Injury Summary report: N

    USSC

    MDR report key: 58297 · Received August 22, 1996

    Report

    Report Number
    58297
    Event Type
    Injury
    Date Received
    August 22, 1996
    Date of Event
    March 9, 1996
    Report Date
    April 11, 1996
    Manufacturer
    AUTO SUTURE
    Product Code
    DSS
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NJ, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PT RETURNED TO OR POST RIGHT CAORTID ENDARTERECTOMY. PHYSICIAN STATES CLIPS FELL OFF OF CAROTID ARTERY INCISION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 USSC Implant VASCULAR CLIP/STAPLE DSS AUTO SUTURE UNK *

    Patients

    Seq Age Sex Outcome Treatment
    1 76 YR Required Intervention