FDA Adverse Event Malfunction Summary report: N

LIGAMAX-5MM

MDR report key: 1872858 · Received October 18, 2010

Report

Report Number
3005075853-2010-05910
Event Type
Malfunction
Date Received
October 18, 2010
Date of Event
August 17, 2010
Report Date
August 18, 2010
Manufacturer
ETHICON ENDO-SURGERY, LLC.
Product Code
FZP
PMA / PMN Number
K050344
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). DEVICE FIRED THROUGH LOCKOUT THE ANALYSIS RESULTS FOUND THAT THE DEVICE WAS RECEIVED IN GOOD VISUAL CONDITION. UPON CYCLING THE DEVICE, IT WAS NOTED TO BE EMPTY AND THE LOCKOUT HAD BEEN FIRED THROUGH. PLEASE NOTE THE DEVICE CONTAINS A LOCKOUT FEATURE THAT IS DESIGNED TO INCREASE THE REQUIRED FORCE IT TAKES TO CLOSE THE TRIGGER ONCE THE LAST CLIP HAS BEEN FIRED; THIS REDUCES THE POSSIBILITY OF EMPTY JAWS BEING CLOSED ON A STRUCTURE. IN ADDITION, IF THE TRIGGER IS FORCED CLOSED ONCE THE LOCKOUT HAS BEEN ENGAGED, THE JAWS MAY REMAIN IN THE CLOSED POSITION. DUE TO THE CONDITION OF THE DEVICE, NO FUNCTIONAL TESTING COULD BE PERFORMED TO EVALUATE THE REPORTED INCIDENT. THE BATCH RECORD WAS REVIEWED AND NO ANOMALIES WERE NOTED DURING THE MANUFACTURING PROCESS.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A ENDOSCOPIC SAPHENOUS VEIN HARVESTING PROCEDURE THE DEVICE WAS FIRED THREE TIMES AND THE CLIPS WERE FINE. ON THE FOURTH FIRING THE DEVICE DID NOT FIRE ANY MORE CLIPS. IT WAS LIKE THE DEVICE WAS EMPTY. ANOTHER DEVICE WAS USED TO COMPLETE THE CASE WITH NO PATIENT CONSEQUENCE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LIGAMAX-5MM CLIP, IMPLANTABLE FZP ETHICON ENDO-SURGERY, LLC. NA G4TE8H

Patients

Seq Age Sex Outcome Treatment
1