FDA Adverse Event Injury Summary report: N

HEM-O-LOK ML POLYMER CLIPS

MDR report key: 631814 · Received August 29, 2005

Report

Report Number
1044475-2005-00011
Event Type
Injury
Date Received
August 29, 2005
Date of Event
July 1, 2005
Report Date
August 29, 2005
Manufacturer
WECK, TELEFLEX MEDICAL
Product Code
FZP
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NH, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

PROCEDURE: LAPAROSCOPIC NEPHRECTOMY A LAPAROSCOPIC NEPHRECTOMY WAS PERFORMED ON A PT USING HEM-O-LOK ML POLYMER CLIPS. TWO HEM-O-LOK ML CLIPS WERE USED TO LIGATE THE RENAL ARTERY WITH A 1-2 MM CUFF. APPROX 3-4 HOURS POST-OP, THE PT EXPERIENCED A DROP IN BLOOD PRESSURE. THE PT WAS REOPENED AND SITE OF LIGATION WAS MISSING THE TWO CLIPS. SURGEON REPAIRED THE SITE BY SUTURE. PT REQUIRED 11 PINTS OF BLOOD TRANSFUSED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEM-O-LOK ML POLYMER CLIPS POLYMER LIGATION CLIPS FZP WECK, TELEFLEX MEDICAL NA 1997068

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Life Threatening| R