BEUDAMED
    FDA Adverse Event Other Summary report: N

    ETHICON ENDO SURGERY, INC

    MDR report key: 826869 · Received March 7, 2007

    Report

    Report Number
    MW1042168
    Event Type
    Other
    Date Received
    March 7, 2007
    Date of Event
    December 15, 2006
    Manufacturer
    ETHICON ENDO SURGERY, INC
    Product Code
    GCJ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING SURGERY ENDOSCOPIC STAPLER WOULD ONLY CLAMP BUT NOT FIRE THE STAPLES. NEW STAPLER USED AND FUNCTIONED PROPERLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETHICON ENDO SURGERY, INC ENDOPATH ETS COMPACT-FLEX 45 ARTICULATING LINEAR CUTTER GCJ ETHICON ENDO SURGERY, INC 45MM STAPLE LINE 2.5MM LG C4D142

    Patients

    Seq Age Sex Outcome Treatment
    1 37 YR Other