FDA Adverse Event Malfunction Summary report: N

COOL-TIP RF SYS 100V ENG

MDR report key: 1163296 · Received September 9, 2008

Report

Report Number
1717344-2008-00419
Event Type
Malfunction
Date Received
September 9, 2008
Date of Event
August 13, 2008
Report Date
August 18, 2008
Manufacturer
COVIDIEN LP, VALLEYLAB
Product Code
GEI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

DATE OF INITIAL REPORT: 09/09/2008. TO DATE THE INCIDENT SAMPLE HAS NOT BEEN REC'D FOR EVAL. IF THE SAMPLE IS REC'D 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 STATES THAT DURING A RADIOFREQUENCY ABLATION, THE MESSAGE "RF INTERRUPTED PRESS TIMER RESET" APPEARED IN GENERATOR MESSAGE WINDOW. THE GENERATOR WAS REBOOTED TWICE, BUT NOTHING CHANGED AND NO POWER WAS DELIVERED. THE DR ALSO TRIED REPLACING THE NEEDLE TWICE, BUT THE PROCEDURE HAD TO BE ABORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COOL-TIP RF SYS 100V ENG RF ABLATION GENERATOR GEI COVIDIEN LP, VALLEYLAB

Patients

Seq Age Sex Outcome Treatment
1 69 YR