FDA Adverse Event Injury Summary report: N

GYNECARE MORCELLEX TISSUE MORCELLATOR

MDR report key: 1173373 · Received September 22, 2008

Report

Report Number
2210968-2008-00839
Event Type
Injury
Date Received
September 22, 2008
Date of Event
August 11, 2008
Report Date
August 20, 2008
Manufacturer
ETHICON, INC.
Product Code
HET
PMA / PMN Number
K061050
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DATE SENT TO THE FDA: 09/19/2008. BLEEDING OCCURRED. CONCLUSION: NO CONCLUSION CAN BE DRAWN AT THIS TIME. SHOULD ADDITIONAL INFO BE OBTAINED, A SUPPLEMENTAL 3500A FORM WILL BE SUBMITTED ACCORDINGLY.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PT UNDERWENT ROBOTIC LAPAROSCOPIC SUPRACERVICAL HYSTERECTOMY IN 2008. DURING THE PROCEDURE, AS SOON AS THE TROCAR WAS PLACED, A MAJOR VASCULAR INJURY WITH BLEEDING OCCURRED. A VASCULAR SURGEON PERFORMED A MESH PLACEMENT TO REPAIR THE VESSEL AND THE PT WAS SENT TO THE INTENSIVE CARE UNIT. CURRENTLY, THE PT IS DOING BETTER AND IS AT HOME. THE SURGEON OPINES THAT THE DEVICE OBTURATOR IS NOT FLUSH WITH THE SHEATH AND CAUGHT ON THE PATIENT'S SKIN/VESSEL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GYNECARE MORCELLEX TISSUE MORCELLATOR LAPAROSCOPE, GYNECOLOGIC HET ETHICON, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention