HOL L ENDO APPLIER 10MM 45CM 544995L

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-04-12 for HOL L ENDO APPLIER 10MM 45CM 544995L manufactured by Teleflex Medical.

Event Text Entries

[105536469] (b)(4). The device has not been returned for investigation. Teleflex will continue to monitor and trend related events.
Patient Sequence No: 1, Text Type: N, H10


[105536470] It was reported that the applier handle seemed loose and after opening and closing it a few times, it was apparent something was broken. The jaws stayed in the closed position and had to be opened manually. There was no reported patient injury.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3011137372-2018-00109
MDR Report Key7425834
Date Received2018-04-12
Date of Report2018-03-26
Date of Event2018-03-22
Date Mfgr Received2018-06-04
Date Added to Maude2018-04-12
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 ContactJASMINE BROWN
Manufacturer Street3015 CARRINGTON MILL BLVD
Manufacturer CityMORRISVILLE NC 27560
Manufacturer CountryUS
Manufacturer Postal27560
Manufacturer Phone9193614124
Manufacturer G1TELEFLEX MEDICAL
Manufacturer Street3015 CARRINGTON MILL BLVD
Manufacturer CityMORRISVILLE NC 27560
Manufacturer CountryUS
Manufacturer Postal Code27560
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameHOL L ENDO APPLIER 10MM 45CM
Product CodeHBT
Date Received2018-04-12
Catalog Number544995L
Lot Number06E1751086
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerTELEFLEX MEDICAL
Manufacturer AddressRESEARCH TRIANGLE PARK NC


Patients

Patient NumberTreatmentOutcomeDate
10 2018-04-12

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