ETHICON ENDOSCOPIC CLIP APPLIER

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-02-11 for ETHICON ENDOSCOPIC CLIP APPLIER manufactured by Ethicon Endo-surgery, Inc..

Event Text Entries

[179312760] The dr was using this clip applier and it would not fire. A second device was opened and worked fine. No pt harm with this.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5092942
MDR Report Key9699728
Date Received2020-02-11
Date of Report2020-01-23
Date of Event2020-01-22
Date Added to Maude2020-02-12
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameETHICON ENDOSCOPIC CLIP APPLIER
Generic NameAPPLIER, HEMOSTATIC CLIP
Product CodeHBT
Date Received2020-02-11
Returned To Mfg2020-01-23
Lot NumberT95820
Device AvailabilityR
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerETHICON ENDO-SURGERY, INC.


Patients

Patient NumberTreatmentOutcomeDate
10 2020-02-11

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