MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-08-08 for ETHICON 01PSEE45A manufactured by Ethicon Endo-surgery, Inc..
| Report Number | MW5089031 |
| MDR Report Key | 8894288 |
| Date Received | 2019-08-08 |
| Date of Report | 2019-07-12 |
| Date of Event | 2019-07-10 |
| Date Added to Maude | 2019-08-14 |
| Event Key | 0 |
| Report Source Code | Voluntary report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | RISK MANAGER |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | ETHICON |
| Generic Name | STAPLER, SURGICAL |
| Product Code | GAG |
| Date Received | 2019-08-08 |
| Model Number | 01PSEE45A |
| Lot Number | T9300U |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ETHICON ENDO-SURGERY, INC. |
| Manufacturer Address | CINCINNATI OH US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-08-08 |