FDA Adverse Event Malfunction Summary report: N

SMOKE TELE PENCIL COATED PB

MDR report key: 15259701 · Received August 19, 2022

Report

Report Number
0001811755-2022-00033
Event Type
Malfunction
Date Received
August 19, 2022
Date of Event
July 25, 2022
Report Date
October 24, 2022
Manufacturer
STRYKER INSTRUMENTS-KALAMAZOO
Product Code
GEI
UDI-DI
37613327466332
PMA / PMN Number
K182354
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

A FOLLOW UP REPORT WILL BE FILED ONCE THE QUALITY INVESTIGATION IS COMPLETE. DEVICE DISCARDED.

Additional Manufacturer Narrative · 0

H6: THE QUALITY INVESTIGATION IS COMPLETE. H3 OTHER TEXT : DEVICE NOT RETURNED, PHOTOGRAPH PROVIDED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING AN ORTHOPAEDIC PROCEDURE, THE SURGEON USED THE E-SEP PENCIL TO CREATE A TEMPORARY BIPOLAR DEVICE. THE SURGEON BROUGHT IT OFF THE FIELD SHORTLY AFTER DOING THIS, AND CONSIDERED IT CHARRED. IT WAS ALSO REPORTED THAT THERE WAS A TWO MINUTE DELAY AS A RESULT OF THIS EVENT. IT WAS FURTHER REPORTED THAT THERE WERE NO ADVERSE CONSEQUENCES AS A RESULT OF THIS EVENT AND THE PROCEDURE WAS COMPLETED SUCCESSFULLY.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING AN ORTHOPAEDIC PROCEDURE, THE SURGEON USED THE E-SEP PENCIL TO CREATE A TEMPORARY BIPOLAR DEVICE. THE SURGEON BROUGHT IT OFF THE FIELD SHORTLY AFTER DOING THIS, AND CONSIDERED IT CHARRED. IT WAS ALSO REPORTED THAT THERE WAS A TWO MINUTE DELAY AS A RESULT OF THIS EVENT. IT WAS FURTHER REPORTED THAT THERE WERE NO ADVERSE CONSEQUENCES AS A RESULT OF THIS EVENT AND THE PROCEDURE WAS COMPLETED SUCCESSFULLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1847946 SMOKE TELE PENCIL COATED PB ELECTROSURGICAL CUTTING AND COAGULATION DEVICE AND ACCESSORIES GEI STRYKER INSTRUMENTS-KALAMAZOO 2003021 37613327466332

Patients

Seq Age Sex Outcome Treatment
1 Unknown