FDA Adverse Event Malfunction Summary report: N

E.S. UNIT, F2-8PC UPGRADE

MDR report key: 1001286 · Received February 15, 2008

Report

Report Number
1717344-2008-00053
Event Type
Malfunction
Date Received
February 15, 2008
Date of Event
January 18, 2008
Report Date
January 20, 2008
Manufacturer
COVIDIEN LP (VALLEYLAB)
Product Code
GEI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DATE OF INITIAL REPORT : 02/19/2008. THE GENERATOR WAS RETURNED TO AND TESTED BY COVIDIEN AND FOUND TO FUNCTION TO SPECIFICATION. FOLLOW-UP MEETINGS WITH HOSPITAL REPRESENTATIVES TOOK PLACE TO DISCUSS THE INCIDENT. PROBABLE CAUSE WAS BELIEVED TO BE USER ERROR WHEN AN ES PENCIL WAS LAID NEXT TO THE PATIENT'S ARM AND WAS ACTIVATED WHEN THE FOOT PEDAL WAS ACCIDENTALLY PUSHED.

Description of Event or Problem · 1

THE REPORT STATED A PATIENT HAS BEEN BURNED ON THE LEFT ARM. IT IS A BURN OF APPROXIMATELY 20MM LONG X 5MM WIDE. THE HOSPITAL DOES NOT USE COVIDIEN PENCILS, ELECTRODES OR PATIENT RETURN ELECTRODES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 E.S. UNIT, F2-8PC UPGRADE ELECTROSURGICAL GENERATOR GEI COVIDIEN LP (VALLEYLAB)

Patients

Seq Age Sex Outcome Treatment
1 UNK