FDA Adverse Event Malfunction Summary report: N

SMOKE EVAC. PENCIL COATED RS,NON-STERILE

MDR report key: 16126691 · Received January 9, 2023

Report

Report Number
0001811755-2023-00002
Event Type
Malfunction
Date Received
January 9, 2023
Date of Event
December 12, 2022
Report Date
May 16, 2023
Manufacturer
STRYKER INSTRUMENTS-KALAMAZOO
Product Code
GEI
UDI-DI
37613327117203
PMA / PMN Number
K143145
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

A FOLLOW-UP REPORT WILL BE FILED ONCE THE QUALITY INVESTIGATION IS COMPLETE. AWAITING CONFIRMATION IF DEVICE IS AVAILABLE FOR RETURN.

Additional Manufacturer Narrative · 0

D4: INITIAL MDR REPORTED CATALOG NUMBER 0703047000, UPDATED TO 0703047002.

Additional Manufacturer Narrative · 0

H6: THE QUALITY INVESTIGATION IS COMPLETE.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING SET UP FOR A PROCEDURE, THE BUTTON OF THE E-SEP PENCIL WAS ALREADY IN "CUT" MODE WHEN IT WAS PLUGGED IN, WITHOUT PUSHING IT. THE PROCEDURE WAS COMPLETED SUCCESSFULLY WITHOUT A CLINICALLY SIGNIFICANT DELAY; NO ADVERSE CONSEQUENCES OR MEDICAL INTERVENTION WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING SET UP FOR A PROCEDURE, THE BUTTON OF THE E-SEP PENCIL WAS ALREADY IN "CUT" MODE WHEN IT WAS PLUGGED IN, WITHOUT PUSHING IT. THE PROCEDURE WAS COMPLETED SUCCESSFULLY WITHOUT A CLINICALLY SIGNIFICANT DELAY; NO ADVERSE CONSEQUENCES OR MEDICAL INTERVENTION WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING SET UP FOR A PROCEDURE, THE BUTTON OF THE E-SEP PENCIL WAS ALREADY IN "CUT" MODE WHEN IT WAS PLUGGED IN, WITHOUT PUSHING IT. THE PROCEDURE WAS COMPLETED SUCCESSFULLY WITHOUT A CLINICALLY SIGNIFICANT DELAY; NO ADVERSE CONSEQUENCES OR MEDICAL INTERVENTION WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
205020 SMOKE EVAC. PENCIL COATED RS,NON-STERILE ELECTROSURGICAL CUTTING AND COAGULATION DEVICE AND ACCESSORIES GEI STRYKER INSTRUMENTS-KALAMAZOO UNKNOWN 37613327117203

Patients

Seq Age Sex Outcome Treatment
1 Unknown