BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ENDOSTAT II ELECTROSURGICAL UNIT

    MDR report key: 1160048 · Received September 12, 2008

    Report

    Report Number
    3005099803-2008-04533
    Event Type
    Malfunction
    Date Received
    September 12, 2008
    Date of Event
    August 12, 2008
    Report Date
    August 14, 2008
    Manufacturer
    BOSTON SCIENTIFIC CORPORATION
    Product Code
    KNS
    PMA / PMN Number
    K913881
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THE COMPLAINANT WAS UNABLE TO PROVIDE THE SUSPECT DEVICE LOT NUMBER; THEREFORE, THE DEVICE MANUFACTURER DATE IS UNKNOWN. ACCORDING TO THE COMPLAINANT, THE SUSPECT DEVICE IS NOT AVAILABLE FOR RETURN. A DEVICE EVALUATION CANNOT BE PERFORMED; THE CAUSE OF THE REPORTED MALFUNCTION IS UNDETERMINED.

    Description of Event or Problem · 1

    IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION IN 2008 THAT AN ENDOSTAT II ELECTROSURGICAL UNIT HAD NO OUTPUT FROM THE GENERATOR WHEN IT WAS TESTED ABOUT TWO DAYS PRIOR. THE GENERATOR WAS NOT USED. THERE WAS NO PATIENT INVOLVEMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ENDOSTAT II ELECTROSURGICAL UNIT KNS BOSTON SCIENTIFIC CORPORATION M0054080R0 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 NA