FDA Adverse Event Malfunction Summary report: N

HARMONIC ACE 36 CM

MDR report key: 1823685 · Received November 16, 2007

Report

Report Number
1527736-2007-07812
Event Type
Malfunction
Date Received
November 16, 2007
Date of Event
October 5, 2007
Report Date
November 13, 2007
Manufacturer
ETHICON ENDO SURGERY, INC. (CINCINNATI)
Product Code
LFL
PMA / PMN Number
K042777
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
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 A LAP ANTERIOR RESECTION, THE HARMONIC MADE A SOLID ERROR TONE - NO ERROR CAME UP ON THE SCREEN. TROUBLE SHOOTING WAS FOLLOWED BUT STILL JUST A SOLID ERROR TONE. WENT TO CHANGE DISPOSABLE AND THE BLADE TIP CAME OFF. THERE WAS NO PATIENT CONSEQUENCE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HARMONIC ACE 36 CM LFL ETHICON ENDO SURGERY, INC. (CINCINNATI) NA D4HT92

Patients

Seq Age Sex Outcome Treatment
1 GENERATOR| HANDPIECE