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