FDA Adverse Event Malfunction Summary report: N

LHE CURVED SPATULA TIP

MDR report key: 1082437 · Received July 21, 2008

Report

Report Number
1717344-2008-00329
Event Type
Malfunction
Date Received
July 21, 2008
Date of Event
June 1, 2008
Report Date
June 25, 2008
Manufacturer
COVIDIEN LP (VALLEYLAB)
Product Code
GEI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DATE OF INITIAL REPORT : 07/21/2008. THE INCIDENT DEVICE HAS BEEN RECEIVED AND IS UNDER EVALUATION. WHEN THE DEVICE EVALUATION IS COMPLETE A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

THE REPORT STATED THAT THE SURGEON HAD MODIFIED THE TIP BY BENDING IT. DURING SURGERY, THE TIP FELL OFF AND INTO THE PATIENT. IT WAS RETRIEVED AND THE PROCEDURE COMPLETED WITHOUT HARM TO THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LHE CURVED SPATULA TIP ELECTROSURGICAL ACCESSORY GEI COVIDIEN LP (VALLEYLAB) 138493

Patients

Seq Age Sex Outcome Treatment
1 UNK