MAUDE Adverse Event Report: FILSHIE CLIP

Device Problem Positioning Problem (3009)

Patient Problem No Information (3190)

Event Date 05/01/2015

Event Type  No Answer Provided  

Event Description

Had filshie clip inserted to prevent pregnancy.The inserting doctor told me that she was uncertain if one of the clips clipped into place so she also burned the tubes as well.

• Brand Name: FILSHIE CLIP
• Type of Device: FILSHIE CLIP
• MDR Report Key: 7633789
• MDR Text Key: 112291543
• Report Number: MW5078028
• Device Sequence Number: 1
• Product Code: KNH
• Combination Product (y/n): N
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Voluntary
• Reporter Occupation: Patient
• Type of Report: Initial
• Report Date: 06/21/2018

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 06/22/2018
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Was Device Available for Evaluation?: Yes
• Was Device Evaluated by Manufacturer?: No Information
• Type of Device Usage: N
• Patient Sequence Number: 1
• Patient Outcome(s): Other
• Patient Age: 26 YR
• Patient Weight: 79