• Decrease font size
  • Return font size to normal
  • Increase font size
U.S. Department of Health and Human Services

MAUDE Adverse Event Report: WILSON-COOK MEDICAL INC. COOK MEDICAL 4,6,10 SHOOTER SAEED MULTI-BAND LIGATOR

  • Print
  • Share
  • E-mail
-
Super Search Devices@FDA
510(k) | DeNovo | Registration & Listing | Adverse Events | Recalls | PMA | HDE | Classification | Standards
CFR Title 21 | Radiation-Emitting Products | X-Ray Assembler | Medsun Reports | CLIA | TPLC
 

WILSON-COOK MEDICAL INC. COOK MEDICAL 4,6,10 SHOOTER SAEED MULTI-BAND LIGATOR Back to Search Results
Model Number MBL-6-OV
Device Problem Activation, Positioning or SeparationProblem (2906)
Patient Problem No Information (3190)
Event Date 12/29/2015
Event Type  Injury  
Event Description
Banding mechanism did not deploy appropriately. Banding was unsuccessful.
 
Search Alerts/Recalls

  New Search  |  Submit an Adverse Event Report

Brand NameCOOK MEDICAL 4,6,10 SHOOTER SAEED MULTI-BAND LIGATOR
Type of DeviceBAND LIGATOR
Manufacturer (Section D)
WILSON-COOK MEDICAL INC.
winston salem NC 27105
MDR Report Key5427728
MDR Text Key37976435
Report NumberMW5060087
Device Sequence Number1
Product Code FER
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Voluntary
Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date 02/05/2016
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/05/2016
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator
Device Model NumberMBL-6-OV
Device Lot NumberW3650380
Was Device Available for Evaluation? No Answer Provided
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA?
Event Location No Information
Was Device Evaluated by Manufacturer? No Answer Provided
Is the Device Single Use? No Answer Provided
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage

Patient Treatment Data
Date Received: 02/05/2016 Patient Sequence Number: 1
-
-