This clamp was invented in 1954 by Rabbi Harry Bronstein. Since then it was used
mainly in Jewish community for their sons ritual circumcision. From 1980s, US
physicians started to use the clamp for medical indications of newborn circumcision.
The main principle of the clamp was to 'shield' the glans from the scalpel while
crushing the unwanted foreskin.
A more detailed procedure of how the clamp was applied can be found in:
Potential for Injury from Circumcision Clamps
Date: August 29, 2000
This letter is to alert you to the potential for injury from two commonly used
circumcision clamps, the Gomco®/gomco-type and Mogen®/mogen-type clamps.
Both are widely used during circumcision to remove the foreskin while protecting the
Although research suggests that circumcision is generally a safe procedure, we are
concerned that some serious device-related complications have occurred. We received
105 reports of injuries involving circumcision clamps between July 1996 and January
20001. These have included laceration, hemorrhage, penile amputation, and urethral
We are providing recommendations below that can help avoid these complications.
Nature of the Problem
Gomco® and Gomco-type Clamps
The use of Gomco® and gomco-type clamps that have been reassembled by users with
parts from different manufacturers, or that have bent parts or mismatched
components, has led to clamps breaking, slipping, falling off during use, tearing penile
tissue or failing to make a tight seal. Please note that although Gomco® and
gomco-type clamps may appear to have interchangeable parts, these parts may not
always be safely interchanged because they may vary slightly in dimensions.
Mogen® and Mogen-type Clamps
The use of Mogen® and mogen-type clamps that have jaw gap dimensions greater
than those in the manufacturer's specifications, or use of clamps inappropriately sized
for patients, has led to patient injuries. In such cases, the clamp may allow too much
tissue to be drawn through the opening of the device, thus facilitating the removal of
an excessive amount of foreskin and in some cases, a portion of the glans penis.
Before performing a circumcision procedure, examine the clamp to determine that all
parts are available, undamaged, and within the manufacturer’s specification.
Gomco® and Gomco-type clamps:
* If you cannot be certain that a clamp component is part of the original clamp or if
the clamp has stripped threads, a warped or bent base plate, a bent arm, twisted forks,
or a scored or nicked bell, either contact the device manufacturer to obtain
replacement parts2 or discard the clamp.
* When requesting a replacement part, obtain the assurance of the manufacturer or
supplier that the part ordered is compatible with the other components of your device.
Do not substitute parts from different clamp manufacturers.
* Make sure that you reassemble a clamp from only its own parts. Do not mix up parts
from different clamps, even from the same manufacturer, unless the manufacturer has
assured you that the parts are interchangeable.
* If you choose to mark clamp parts to assure that you correctly reassemble them, ask
the manufacturer about the best way to do this, because some marking methods may
weaken the device or compromise your ability to sterilize it.
Mogen® and Mogen-type clamps:
* Ensure that the clamp being used is appropriate for the patient size. Some
manufacturers have two sizes of clamps, one for adults and the other for infants.
* Periodically measure the gap between the device’s clamping jaws to ensure that it is
within the manufacturer’s specification.3 Using a device with an inappropriate jaw gap
could allow the tip of the penis to be drawn through the clamp with the foreskin and
inadvertently severed or injured.
Reporting Adverse Events to FDA
The Safe Medical Devices Act of 1990 (SMDA) requires hospitals and other user
facilities to report deaths and serious injuries associated with the use of medical
devices. This means that if the use of a Gomco/gomco-type clamp or a
Mogen/mogen-type clamp result in a death or serious injury, you must report that
event. We request that you follow the procedures established by your facility for such
If a circumcision clamp malfunctions, you can report this directly to the manufacturer.
Alternatively, you can report directly to MedWatch, the FDA's voluntary reporting
program. You may submit reports to MedWatch four ways: online to
http://www.accessdata.fda.gov/scripts/medwatch/ by telephone at 1-800-FDA-1088;
by FAX at 1-800-FDA-0178, or by mail to MedWatch, Food and Drug Administration,
HF-2, 5600 Fishers Lane, Rockville, MD 20857.
Getting More information
If you have questions regarding this letter, please contact the Issues Management
Staff, Office of Surveillance and Biometrics (HFZ-510), 1350 Piccard Drive, Rockville,
Maryland, 20850, by fax at 240-276-3356, or by e-mail at email@example.com.
Additionally, a voice mail message may be left at 240-276-3357 and your call will be
returned as soon as possible.
All of the FDA medical device postmarket safety notifications can be found on the
World Wide Web at http://www.fda.gov/cdrh/safety.html. Postmarket safety
notifications can also be obtained through e-mail on the day they are released by
subscribing to our list server. To subscribe, please visit:
David W. Feigal, Jr., MD, MPH
Center for Devices and Radiological Health
Food and Drug Administration
References and Additional Information:
1. FDA MedWatch Reports, July 1992 through January 2000.
2. IPM Procedure: Circumcision Clamps, Health Devices 2000 January; 29(1):22-3.
3. Hazard: Routine inspection needed for scissors-type circumcision clamps, Health
Devices 1999 Mar; 28(3):115-6.
4. Hazard: Incompatibility of different brands of Gomco-Type circumcision clamps.
Health Devices 1997 Feb; 26(2):76-7.
5. Hazard: Amputations with use of adult-size scissors-type circumcision clamps on
infants. Health Devices 1995 Jul; 4(7):286-7.
6. Hazard: Damaged Allied Healthcare Products Gomco circumcision clamp. Health
Devices 1993 Mar; 22(3):154-5.
Circumcision with mogen clamp
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