D
Patient 1
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.
MAUDE MDR 9699728
- MDR report key
- 9699728
- Report number
- MW5092942
- Event key
- 0
- Event type
- 3
- Date of event
- 2020-01-22
- Date received
- 2020-02-11
- Adverse event
- 3
- Product problem
- 3
- Patients in event
- 0
- Reporter occupation
- 500
- Health professional
- 3
- Initial report to FDA
- 3
- Event location
- 3
Manufacturer Contact#
- Report source
- P
- Manufacturer link flag
- N
Devices#
| Seq | Brand | Generic | Manufacturer | Product code | Model | Catalog | Lot | PMA | 510(k) | Implant | Evaluated | Availability |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | ETHICON ENDOSCOPIC CLIP APPLIER | APPLIER, HEMOSTATIC CLIP | ETHICON ENDO-SURGERY, INC. | HBT | T95820 | I | R |
Patients#
| Sequence | Received | Treatment | Outcome |
|---|---|---|---|
| 1 | 2020-02-11 | 0 |