MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-06-19 for LIGACLIP*ENDO LARGE APPLIER EL414 manufactured by Ethicon Endo-surgery, Llc..
[111989936]
(b)(4). Only event year known: 2018. Additional information was requested and the following was obtained: were the clips malformed, not closing? Did the device not fire the clips? Did the clips fall off the tissue? How was the procedure completed? Response: bad formation means malformed.
Patient Sequence No: 1, Text Type: N, H10
[111989937]
It was reported that during an unknown procedure, not clippling with the lt400 clip. There were no patient consequences.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3005075853-2018-10771 |
| MDR Report Key | 7614943 |
| Date Received | 2018-06-19 |
| Date of Report | 2018-06-06 |
| Date Mfgr Received | 2018-08-14 |
| Device Manufacturer Date | 2006-10-30 |
| Date Added to Maude | 2018-06-19 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MILTON GARRETT |
| Manufacturer Street | 475 CALLE C |
| Manufacturer City | GUAYNABO 00969 |
| Manufacturer Postal | 00969 |
| Manufacturer Phone | 5133378865 |
| Manufacturer G1 | ETHICON ENDO-SURGERY, LLC. |
| Manufacturer Street | 475 CALLE C |
| Manufacturer City | GUAYNABO 00969 |
| Manufacturer Postal Code | 00969 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | LIGACLIP*ENDO LARGE APPLIER |
| Generic Name | LIGACLIP LARGE |
| Product Code | HBT |
| Date Received | 2018-06-19 |
| Returned To Mfg | 2018-08-14 |
| Catalog Number | EL414 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ETHICON ENDO-SURGERY, LLC. |
| Manufacturer Address | 475 CALLE C GUAYNABO 00969 00969 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2018-06-19 |