FDA Adverse Event Other Summary report: N

MULTIVAC XL ARTHROWAND

MDR report key: 1373616 · Received May 1, 2009

Report

Report Number
2951580-2009-00025
Event Type
Other
Date Received
May 1, 2009
Date of Event
March 27, 2009
Report Date
April 29, 2009
Manufacturer
ARTHROCARE CORP.
Product Code
GEI
PMA / PMN Number
K083306
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS REPORTED AS RETURNING FOR INVESTIGATION. A FOLLOW UP REPORT WILL BE PROVIDED AFTER THE DEVICE HAS BEEN RETURNED AND COMPLETION OF THE INVESTIGATION. THREE DEVICES, MULTIVAC XL ARTHROWANDS, WERE USED IN THE SAME PROCEDURE. THREE SEPARATE MDR REPORTS WILL BE FILED UNDER MDR 2951580-2009-00026, AND MDR 2951580-2009-00027.

Description of Event or Problem · 1

A CLINICAL INCIDENT INVOLVING THREE MULTIVAC XL ARTHROWANDS WAS REPORTED TO ARTHROCARE CORPORATION. DURING HIP ARTHROSCOPY PROCEDURE, THE ELECTRODES DETACHED FROM THE TIP OF THE THREE WANDS IN THE SURGICAL SITE. THE ELECTRODES REMAIN IN THE PATIENT'S HIP JOINT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MULTIVAC XL ARTHROWAND ELECTROSURGICAL CUTTING & COAGULATON DEVICE GEI ARTHROCARE CORP. NA 6122480-1

Patients

Seq Age Sex Outcome Treatment
1 UNK Other