FDA Adverse Event Malfunction Summary report: N

LIGASURE V SEALER/DIVIDER

MDR report key: 1032396 · Received April 17, 2008

Report

Report Number
1717344-2008-00160
Event Type
Malfunction
Date Received
April 17, 2008
Date of Event
January 1, 2008
Report Date
March 3, 2008
Manufacturer
COVIDIEN LP (VALLEYLAB)
Product Code
GEI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BE
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TO DATE, THE INCIDENT SAMPLE HAS NOT BEEN RECEIVED FOR EVAL. ADD'L QUESTIONS IN REGARD TO THE INCIDENT HAVE ALSO BEEN ASKED. IF THE SAMPLE IS RECEIVED OR IF ADD'L INFO PERTINENT TO THE INCIDENT IS OBTAINED, A F/U REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

THE REPORT STATED THAT THE LIGASURE V HANDPIECE WAS USED DURING A LAPAROSCOPIC GASTRECTOMY AND A ROUX-EN-Y. THE CUSTOMER REPORTED THAT THERE WERE FLAMES AT THE TIP OF THE DEVICE DURING USAGE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LIGASURE V SEALER/DIVIDER LIGASURE VESSEL SEALING SYSTEM GEI COVIDIEN LP (VALLEYLAB) 135547

Patients

Seq Age Sex Outcome Treatment
1 UNK