FDA Adverse Event Injury Summary report: N

HEM-O-LOK L LIGATION CLIPS

MDR report key: 640734 · Received October 14, 2005

Report

Report Number
1044475-2005-00014
Event Type
Injury
Date Received
October 14, 2005
Date of Event
September 1, 2005
Report Date
October 14, 2005
Manufacturer
WECK, TELEFLEX MEDICAL
Product Code
FZP
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

WECK, TELEFLEX MEDICAL RECEIVED NOTICE THAT A PT WAS REQUIRED TO BE REOPENED AFTER A LAPAROSCOPIC DONOR NEPHRECTOMY. AFTER RE-OPENING THE PT, IT WAS OBSERVED THAT THE TWO HEM O-LOK CLIPS USED TO LIGATE THE ARTERIAL SIDE OF THE PT WAS NO LONGER ON THE LIGATION SITE. THE ARTERIAL CUFF WAS RE LIGATED AND THE PT IS RECOVERING FINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEM-O-LOK L LIGATION CLIPS LARGE POLYMAR LIGATION CLIP FZP WECK, TELEFLEX MEDICAL NA 1997099

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Life Threatening| R