LIGACLIP*ENDO MED/LG APPLIER EL314

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-09-27 for LIGACLIP*ENDO MED/LG APPLIER EL314 manufactured by Ethicon Endo-surgery, Llc..

Event Text Entries

[87742652] (b)(4). Attempts have been made to retrieve the device. To date the device has not been returned. If the device or further details are received at a later date a supplemental medwatch will be sent. Attempts are being made to obtain the following information. To date no response has been provided. If further details are received at a later date a supplemental medwatch will be sent. What is the correct procedure date and what is the correct event date as you have the procedure date as (b)(6) 2017 and the event date as (b)(6) 2017? Was there only one procedure? Or was there a re-operation? If there was a re-operation, what was the reason for re-operation?
Patient Sequence No: 1, Text Type: N, H10


[87742653] It was reported that during a cholecystectomy, when they clipped the cystic duct the two clips went out of place. Luckily, there were no adverse effects on the patient. There clips were released. They used another chalanger. There was no need to re-operate. There was no serious damage. There were no patient consequences.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3005075853-2017-05220
MDR Report Key6898274
Date Received2017-09-27
Date of Report2017-09-07
Date of Event2017-09-06
Date Mfgr Received2018-01-04
Device Manufacturer Date2014-11-30
Date Added to Maude2017-09-27
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMILTON GARRETT
Manufacturer Street475 CALLE C
Manufacturer CityGUAYNABO 00969
Manufacturer Postal00969
Manufacturer Phone5133378865
Manufacturer G1ETHICON ENDO-SURGERY, LLC.
Manufacturer Street475 CALLE C
Manufacturer CityGUAYNABO 00969
Manufacturer Postal Code00969
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameLIGACLIP*ENDO MED/LG APPLIER
Generic NameLIGACLIP
Product CodeHBT
Date Received2017-09-27
Returned To Mfg2018-01-03
Catalog NumberEL314
Lot NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerETHICON ENDO-SURGERY, LLC.
Manufacturer Address475 CALLE C GUAYNABO 00969 00969


Patients

Patient NumberTreatmentOutcomeDate
10 2017-09-27

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