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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: FILSHIE CLIPS LAPAROSCOPIC CONTRACEPTIVE TUBAL OCCLUSION DEVICE

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FILSHIE CLIPS LAPAROSCOPIC CONTRACEPTIVE TUBAL OCCLUSION DEVICE Back to Search Results
Device Problem Migration or Expulsion of Device (1395)
Patient Problem Insufficient Information (4580)
Event Date 09/20/2018
Event Type  Injury  
Event Description
Had to have 4 filshie clamps removed that has migrated throughout my pelvic/abdominal cavity. Had no medical conditions at time of filshie clamps as they were placed in 2009s. Fda safety report id# (b)(4).
 
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Brand NameFILSHIE CLIPS
Type of DeviceLAPAROSCOPIC CONTRACEPTIVE TUBAL OCCLUSION DEVICE
MDR Report Key12815028
MDR Text Key280928661
Report NumberMW5105337
Device Sequence Number1
Product Code KNH
Combination Product (y/n)N
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Voluntary
Reporter Occupation Patient
Type of Report Initial
Report Date 11/11/2021
4 Devices were Involved in the Event: 1   2   3   4  
1 Patient was Involved in the Event
Date FDA Received11/12/2021
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No Answer provided

Patient Treatment Data
Date Received: 11/12/2021 Patient Sequence Number: 1
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