FDA Adverse Event Malfunction Summary report: N

PKS OMNI INSRUMENT, 33CM

MDR report key: 1638780 · Received March 17, 2010

Report

Report Number
2183680-2010-00012
Event Type
Malfunction
Date Received
March 17, 2010
Date of Event
February 4, 2010
Report Date
March 17, 2010
Manufacturer
GYRUS MEDICAL INC.
Product Code
GEI
PMA / PMN Number
K081766
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS BEEN DISCARDED. AS A RESULT, A DETERMINATION CANNOT BE MADE. IF FURTHER INFO BECOMES AVAILABLE, GYRUS ACMI WILL CONTINUE THE INVESTIGATION AND UPDATE THE AGENCY ACCORDINGLY.

Description of Event or Problem · 1

DURING A TLH PROCEDURE, WHILE USING THE PKS OMNI INSTRUMENT, COAG APPEARED WEAK AND INEFFICIENT. THE SURGEON TRIED COAG SETTINGS FROM 60-100 TO GET BETTER COAG. THE HOSPITAL G400 GENERATOR WAS USED AT THE HC2 SETTING. THERE WAS NO PT HARM. THE SAME DEVICE WAS USED TO COMPLETE THE CASE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PKS OMNI INSRUMENT, 33CM PKS OMNI INSTRUMENT, 33CM GEI GYRUS MEDICAL INC. 970010PC UNK

Patients

Seq Age Sex Outcome Treatment
1