FDA Adverse Event
Malfunction
Summary report: N
SPIDER - FLEX MONOPOLAR HOOK
MDR report key: 1781095
·
Received July 29, 2010
Report
- Report Number
- 3007593944-2010-00006
- Event Type
- Malfunction
- Date Received
- July 29, 2010
- Date of Event
- July 2, 2010
- Report Date
- July 29, 2010
- Manufacturer
- TRANSENTERIX INC.
- Product Code
- GCJ
- PMA / PMN Number
- K091697
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NC, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Description of Event or Problem · 1
DURING COMPLETION OF A MINIMALLY INVASIVE ABDOMINAL LAPAROSCOPIC SURGERY, THE SURGEON NOTICED THAT THE HOOK END EFFECTER OF THE SPIDER FLEX MONOPOLAR HOOK INSTRUMENT SEPARATED FROM THE INSTRUMENT FLEXIBLE SHAFT INTO THE SURGICAL BED. THE SURGEON WAS ABLE TO LOCATE AND RETRIEVE THE HOOK FROM THE PT WITHIN 7-10 MINUTES DURING THE PROCEDURE AND PRIOR TO CLOSURE. NO INJURY OR IMPACT TO PT CARE WAS REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | SPIDER - FLEX MONOPOLAR HOOK | LAPAROSCOPIC, GENERAL & PLASTIC SURGERY | GCJ | TRANSENTERIX INC. | 9000031 | DSC049201001 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNK |