BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ETHICON ENDOSURGERY INC

    MDR report key: 810809 · Received January 26, 2007

    Report

    Report Number
    MW1041793
    Event Type
    Injury
    Date Received
    January 26, 2007
    Date of Event
    January 11, 2007
    Report Date
    January 26, 2007
    Manufacturer
    *
    Product Code
    GCJ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    WHEN ATTEMPTING TO USE ENDOPATH ETS LINEAR CUTTER WITH RELOAD CARTRIDGE IN PLACE, DEVICE DID NOT "CLICK" WHEN FIRED AND CARTRIDGE FELL INTO ABDOMEN. INCISION HAD TO BE EXTENDED TO REMOVE CARTRIDGE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETHICON ENDOSURGERY INC VASCULAR-THIN-ENDOPATH ETS LINEAR CUTTER AND VASCULAR GCJ * TSW35 C4FTOC
    2 ETHICON ENDOSURGERY INC. VASCULAR-THIN ENDOPATH ETS LINEAR CUTTER AND VASCULAR GCJ * TR35W C4F78W

    Patients

    Seq Age Sex Outcome Treatment
    1 32 YR Disability