BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HS ACE 36CM SCISSOR HANDLE

    MDR report key: 1822158 · Received December 3, 2007

    Report

    Report Number
    1527736-2007-08169
    Event Type
    Malfunction
    Date Received
    December 3, 2007
    Date of Event
    October 31, 2007
    Report Date
    November 15, 2007
    Manufacturer
    ETHICON ENDO-SURGERY, INC. (CINCINNATI)
    Product Code
    LFL
    PMA / PMN Number
    K051036
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). INFORMATION ANTICIPATED, BUT UNAVAILABLE AT THIS TIME. (B)(4).

    Description of Event or Problem · 1

    IT WAS REPORTED THAT DURING AN UNK PROCEDURE, THE HAND ACTIVATION BUTTONS WERE STICKING - REQUIRED TO USE FOOT ACTIVATION INSTEAD. COMPLETED WITH THE SAME LIKE PRODUCT. THERE WAS NO PATIENT CONSEQUENCE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HS ACE 36CM SCISSOR HANDLE LFL ETHICON ENDO-SURGERY, INC. (CINCINNATI) NA C4D74X

    Patients

    Seq Age Sex Outcome Treatment
    1 HANDPIECE| GENERATOR