BEUDAMED
    FDA Adverse Event Other Summary report: N

    SURGICAL SPRING CLIPS-DOUBLE SOFT, 6MM

    MDR report key: 955479 · Received April 16, 2007

    Report

    Report Number
    2027111-2007-00020
    Event Type
    Other
    Date Received
    April 16, 2007
    Date of Event
    January 24, 2007
    Manufacturer
    APPLIED MEDICAL RESOURCES
    Product Code
    DSS
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    NURSE

    Narratives

    Additional Manufacturer Narrative · 1

    PRODUCT HAS NOT BEEN RETURNED TO MFR FOR EVAL. WHEN PRODUCT IS RETURNED, EVAL WILL BE COMPLETED AND SENT TO FDA.

    Description of Event or Problem · 1

    "TWO SPRING CLIPS BROKE DURING THE CASE INSIDE THE PT'S CHEST. IT BROKE INTO SMALL PIECES."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SURGICAL SPRING CLIPS-DOUBLE SOFT, 6MM SURGICAL SPRING CLIPS DSS APPLIED MEDICAL RESOURCES G-6000 100374701

    Patients

    Seq Age Sex Outcome Treatment
    1 YR Other