BEUDAMED
    FDA Adverse Event Summary report: N

    SALUTE FIXATION DEVICE

    MDR report key: 637398 · Received September 22, 2005

    Report

    Report Number
    1213643-2005-00170
    Date Received
    September 22, 2005
    Date of Event
    August 29, 2005
    Report Date
    August 29, 2005
    Manufacturer
    DAVOL INC., SUB. C.R. BARD, INC.
    Product Code
    GDW
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    STRAIGHT SHOTS. 2 FIRED INTO PATIENT'S BELLY. HOSPITAL UNABLE TO LOCATE RGA 1841S. RECEIVED 08/2005.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SALUTE FIXATION DEVICE ENDOSCOPIC STAPLER AND STAPLES GDW DAVOL INC., SUB. C.R. BARD, INC. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 *