MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-10-23 for AUTO ENDO5 ML AE05ML manufactured by Teleflex Medical.
[124955992]
(b)(4). The device history review for the product auto endo5 ml lot #73d1800210 investigation did not show issues related to the complaint. 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
[124955993]
It was reported that during the operative process of ligation of the clip came out closed without being used.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3003898360-2018-00855 |
| MDR Report Key | 7996414 |
| Date Received | 2018-10-23 |
| Date of Report | 2018-10-12 |
| Date of Event | 2018-09-29 |
| Date Mfgr Received | 2018-11-28 |
| Device Manufacturer Date | 2018-04-08 |
| Date Added to Maude | 2018-10-23 |
| 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 | JASMINE BROWN |
| Manufacturer Street | 3015 CARRINGTON MILL BLVD |
| Manufacturer City | MORRISVILLE NC 27560 |
| Manufacturer Country | US |
| Manufacturer Postal | 27560 |
| Manufacturer Phone | 9193614124 |
| Manufacturer G1 | TELEFLEX MEDICAL |
| Manufacturer Street | RANCHO EL DESCANSO |
| Manufacturer City | TECATE 21478 |
| Manufacturer Country | MX |
| Manufacturer Postal Code | 21478 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | AUTO ENDO5 ML |
| Product Code | GEF |
| Date Received | 2018-10-23 |
| Returned To Mfg | 2018-10-29 |
| Catalog Number | AE05ML |
| Lot Number | 73D1800210 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | TELEFLEX MEDICAL |
| Manufacturer Address | RESEARCH TRIANGLE PARK NC |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2018-10-23 |