WECK HEM-O-LOK * 544240

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2013-12-24 for WECK HEM-O-LOK * 544240 manufactured by Telefex Medical.

Event Text Entries

[4190867] Endowrist clip appliers with weck hem-o-lok clips was being used when the clips would close but not lock. Multiple attempts were made with different clips from different packs. A total of 5 packs and different appliers were used to rule out calibration issues. No blood loss was noted and no incision was made until the clips worked appropriately.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3588765
MDR Report Key3588765
Date Received2013-12-24
Date of Report2013-12-24
Date of Event2013-08-15
Report Date2013-12-24
Date Added to Maude2014-01-23
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Sequence Number: 1

Brand NameWECK HEM-O-LOK
Generic NameLIGATING CLIP
Product CodeHBQ
Date Received2013-12-24
Returned To Mfg2013-08-16
Model Number*
Catalog Number544240
Lot Number01B1300444
ID Number*
OperatorPHYSICIAN
Device AvailabilityR
Device Sequence No1
Device Event Key0
ManufacturerTELEFEX MEDICAL
Manufacturer AddressP O BOX 12600 DURHAM NC 27709 US 27709

Device Sequence Number: 2

Brand NameENDOWRIST
Generic NameSYSTEM, SURGICAL, COMPUTER CONTROLLED INSTRUMENT
Product CodeNAY
Date Received2013-12-24
Model Number*
Catalog Number420230
Lot Number*
ID Number*
Device AvailabilityR
Device Age*
Device Sequence No2
Device Event Key0
ManufacturerTELEFEX MEDICAL
Manufacturer AddressP O BOX 12600 DURHAM CA 27709 US 27709


Patients

Patient NumberTreatmentOutcomeDate
10 2013-12-24

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