FDA Adverse Event Malfunction Summary report: N

ENDOPATH DILATING TIP TROCAR

MDR report key: 155639 · Received March 11, 1998

Report

Report Number
1527736-1998-00688
Event Type
Malfunction
Date Received
March 11, 1998
Report Date
February 11, 1998
Manufacturer
ETHICON ENDO-SURGERY, INC.
Product Code
GCJ
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

TRACKING #.49467. EES #.980976/J. D6: DEVICE RETURNED WITH NO LOT IDENTIFICATION. ENDOPATH DILATING TIP TROCAR: BASED UPON THE INQUIRY INFO RECEIVED, VISUAL EXAMINATION AND FUNCTIONAL TEST, IT WAS CONFIRMED THAT THE REPORTED INCIDENT DURING SURGERY OCCURRED. THE DEVICE WAS EXAMINED AND WOULD NOT ARM AS RECEIVED. THE OBTURATOR HANDLE WELD WAS MEASURED AND FOUND TO BE SKEWED. THE OBTURATOR HANDLE IS WELDED DURING THE ASSEMBLY PROCESS.

Description of Event or Problem · 1

IT WAS REPORTED THE DEVICE WAS USED DURING AN UNKNOWN PROCEDURE. IT WAS REPORTED THE TROCAR WOULD NOT ARM AND STAY ARMED. THERE WAS NO CONSEQUENCE TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDOPATH DILATING TIP TROCAR TROCAR GCJ ETHICON ENDO-SURGERY, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other