FDA Adverse Event Other Summary report: N

SAPHYRE PROBE II 90 DEG. SUCTION

MDR report key: 1278371 · Received December 22, 2008

Report

Report Number
1216828-2008-00006
Event Type
Other
Date Received
December 22, 2008
Date of Event
November 14, 2008
Report Date
November 14, 2008
Manufacturer
SMITH & NEPHEW INC., ENDOSCOPY DIVISION
Product Code
GEI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

NO PRODUCT HAS BEEN RETURNED FOR EVALUATION. (B) (4).

Description of Event or Problem · 1

DURING KNEE ARTHROSCOPY PROCEDURE, ABLATION OCCURRED NOT ONLY AT THE TIP OF THE PROBE BUT FROM THE TIP TO THE BIPOLAR PLATE. THE PT EXPERIENCED EXCESSIVE SOFT TISSUE BURN. NO OTHER INFO IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SAPHYRE PROBE II 90 DEG. SUCTION PROBE GEI SMITH & NEPHEW INC., ENDOSCOPY DIVISION 7210111 120216

Patients

Seq Age Sex Outcome Treatment
1 42 YR