FDA Adverse Event Malfunction Summary report: N

ELECTROSURGERY PROBE PLUS II

MDR report key: 1112659 · Received August 11, 2008

Report

Report Number
3005075853-2008-01084
Event Type
Malfunction
Date Received
August 11, 2008
Date of Event
July 24, 2008
Report Date
July 25, 2008
Manufacturer
ETHICON ENDO-SURGERY, LLC
Product Code
GCJ
PMA / PMN Number
K912492
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INFORMATION ANTICIPATED, BUT UNAVAILABLE AT THIS TIME.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A CHOLECYSTECTOMY PROCEDURE, THE WATER LEAKED FROM THE TUBE, AND THE TIP WAS JAMMED. OTHER DEVICES WERE USED TO COMPLETE THE CASE. THERE WERE NO ADVERSE CONSEQUENCES TO THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ELECTROSURGERY PROBE PLUS II GCJ ETHICON ENDO-SURGERY, LLC NA NI

Patients

Seq Age Sex Outcome Treatment
1