FDA Adverse Event Malfunction Summary report: N

HARMONIC ACE PLUS 7 ADV HEMOSTASIS 36

MDR report key: 17835682 · Received September 28, 2023

Report

Report Number
3005075853-2023-06963
Event Type
Malfunction
Date Received
September 28, 2023
Date of Event
July 28, 2023
Report Date
September 28, 2023
Manufacturer
ETHICON ENDO-SURGERY, LLC.
Product Code
LFL
UDI-DI
10705036014621
PMA / PMN Number
K132612
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

(B)(4). DATE SENT: 9/28/2023. D4 BATCH #: A9C044. INVESTIGATION SUMMARY: THE PRODUCT WAS RETURNED FOR EVALUATION. VISUAL INSPECTION AND FUNCTIONAL TESTING WERE CONDUCTED ON THE RETURNED DEVICE. VISUAL ANALYSIS OF THE RETURNED SAMPLE DETERMINED THAT THE DEVICE WAS RETURNED WITH THE TISSUE PAD DETACHED AND NOT RETURNED. THE DEVICE WAS CONNECTED TO A TEST HAND PIECE AND A GEN11, AND THE DEVICE DID ACTIVATE DURING FUNCTIONAL TESTING. THE DEVICE WAS DISASSEMBLED TO INSPECT THE INTERNAL COMPONENTS AND NO ANOMALIES WERE FOUND.    BASED ON THE CONDITION OF THE TISSUE PAD, A PROBABLE CAUSE OF THIS DAMAGE IS THAT THE CLAMP OF THE DEVICE MAY HAVE BEEN CLOSED AND THE INSTRUMENT ACTIVATED WITHOUT TISSUE PRESENT. CARE SHOULD BE TAKEN NOT TO APPLY PRESSURE BETWEEN THE INSTRUMENT BLADE AND TISSUE PAD WITHOUT HAVING TISSUE BETWEEN THEM. KEEP THE CLAMP ARM OPEN WHEN BACK CUTTING OR WHILE THE BLADE IS ACTIVE WITHOUT TISSUE BETWEEN THE BLADE AND TISSUE PAD TO AVOID DAMAGE TO THE TISSUE PAD. THE RESULTING DAMAGE CONTRIBUTES TO THE REMOVAL OF THE PAD FROM THE CLAMP ARM. THE CLEANING OF THE PAD, NOT IN ACCORDANCE WITH THE IFU, CAN ALSO RESULT IN REMOVAL OF THE PAD DURING USE. IT IS POSSIBLE THAT THE DAMAGED AT THE TISSUE PAD COULD RENDERED IN THE REPORTED TISSUE EFFECT ISSUES. AS PART OF THE QUALITY PROCESS ALL DEVICES ARE MANUFACTURED, INSPECTED, AND RELEASED TO APPROVED SPECIFICATIONS.  A MANUFACTURING RECORD EVALUATION WAS PERFORMED FOR THE FINISHED DEVICE LOT/BATCH A9C044 AND NO NON-CONFORMANCES WERE IDENTIFIED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A PULMONARY SEGMENT RESECTION THE SCALPEL WAS HARD TO COAGULATE. CHANGED TO ANOTHER DEVICE TO COMPLETE SURGERY. THERE WAS NO PATIENT CONSEQUENCE REPORTED. NO ADDITIONAL INFORMATION CAN BE PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2010340 HARMONIC ACE PLUS 7 ADV HEMOSTASIS 36 INSTRUMENT, ULTRASONIC SURGICAL LFL ETHICON ENDO-SURGERY, LLC. A9C044 10705036014621

Patients

Seq Age Sex Outcome Treatment
1 Unknown GENERATOR AND HANDPIECE.