FDA Adverse Event Injury Summary report: N

ENDOWRIST

MDR report key: 19043662 · Received April 4, 2024

Report

Report Number
2955842-2024-12936
Event Type
Injury
Date Received
April 4, 2024
Date of Event
March 11, 2024
Report Date
March 12, 2024
Manufacturer
INTUITIVE SURGICAL, INC
Product Code
GDW
UDI-DI
10886874112868
PMA / PMN Number
K152421
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: BASED ON THE REPORTED EVENT, THE ONLY USED RELOAD RETURNED BY THE SITE FOR RMA, LOT NUMBER: K10230926, DOES NOT MATCH THE LOT NUMBER OF THE IMPLICATED RELOAD, LOT NUMBER: K11231012. HOWEVER, DURING FOLLOW UP, THE SITE STATED THE ASSOCIATED RELOAD WAS RETURNED - SUGGESTING THE SITE IMPLICATED THE INCORRECT LOT NUMBER INITIALLY. DURING FAILURE ANALYSIS IT WAS FOUND THAT THE USED RELOAD HAD ALL PUSHERS DEPLOYED AND NO UNFORMED STAPLES FOUND. THE BLADE WAS AT THE DISTAL END AND NOT EXPOSED AND THERE WAS NO BLADE OR CARTRIDGE DAMAGE FOUND. WHILE THE RELOAD WAS USED IN THE REPORTED COMPLAINT, IT IS UNCLEAR IF IT WAS THE RELOAD ASSOCIATED WITH THE MALFORMED STAPLES.

Additional Manufacturer Narrative · 0

CORRECTION: THE ONLY USED STAPLER 30 RELOAD RETURNED FOR FAILURE ANALYSIS WAS LOT NUMBER: K11231012-0406 (NOT K10230926 AS PREVIOUSLY STATED). WHILE IT WAS CONFIRMED K11231012-0406 WAS USED DURING THE PROCEDURE, IT WAS NOT THE LOT (K10230926) IMPLICATED BY THE CUSTOMER. INTUITIVE SURGICAL, INC. (ISI) RECEIVED SEVEN WHITE STAPLER 30 RELOADS. ALL SEVEN STAPLER RELOADS WERE RETURNED WITHOUT BEING USED. NO DAMAGE WAS FOUND. THE STAPLER RELOADS WERE INSTALLED IN AN IN-HOUSE INSTRUMENT AND THEN PLACED ON AN IN-HOUSE SYSTEM. THE STAPLER RELOADS WERE FIRED WITHOUT ISSUES. ALL THE PUSHERS WERE DEPLOYED AND THE STAPLES FORMED ONTO TEST SHEETS. THE BLADE OF EACH STAPLER RELOAD WAS AT THE DISTAL END AND NOT EXPOSED.

Additional Manufacturer Narrative · 0

THE ENDOWRIST STAPLER 30 CURVED-TIP INSTRUMENT, NOR A RELOAD USED IN THE PROCEDURE, WAS RETURNED TO INTUITIVE SURGICAL, INC. (ISI) FOR ANALYSIS. DURING FOLLOW-UP, IT WAS STATED THAT THE STAPLER WOULD NOT BE RETURNED. FAILURE ANALYSIS SHOWED THAT EACH OF THE RETURNED RELOADS WAS UNOPENED. ADVANCED STAPLER LOGS SHOW THE INSTRUMENT WAS INSTALLED ON THE SYSTEM 2 TIMES AND FIRED TWO WHITE RELOADS. ON INSTALL 1, THE RELOAD LOT NUMBER K10230926-0125 (IMPLICATED RELOAD) WAS INSTALLED, AND CLAMPING AND FIRING WERE COMPLETED SUCCESSFULLY. ON INSTALL 2, THE SECOND WHITE RELOAD WAS INSTALLED, AND CLAMPING AND FIRING WERE COMPLETED SUCCESSFULLY. THE INSTRUMENT WAS THEN REMOVED AND NOT USED AGAIN IN THE PROCEDURE. NO RELEVANT STAPLER-RELATED ERRORS WERE IN THE SYSTEM LOGS. SECTION D10 CONCOMITANT PRODUCTS: ENDOWRIST 30 STAPLER CURVED-TIP INSTRUMENT (PART NUMBER: 470530-8 / LOT NUMBER: T10231120-0010).

Description of Event or Problem · 0

REFER TO H10/H11 FOR FOLLOW-UP INFORMATION.

Description of Event or Problem · 0

REFER TO H11 FOR FOLLOW-UP INFORMATION.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED PULMONARY LOBECTOMY, THE ENDOWRIST STAPLER 30 INSTRUMENT PRODUCED MALFORMED STAPLES, A SMALL CLIP APPLIER INSTRUMENT WAS USED TO SEAL THE TISSUE, AND THE PROCEDURE WAS COMPLETED ROBOTICALLY. DURING FOLLOW-UP WITH THE ROBOTICS COORDINATOR (ROCO), IT WAS STATED THAT AFTER FIRING THE STAPLER, THE SURGEON NOTICED THE STAPLES WERE NOT CLOSED ALL THE WAY. THE STAPLES WERE NOT REMOVED. INSTEAD, THE SMALL CLIP APPLIER INSTRUMENT WAS USED OVER THE STAPLES. NO OTHER INTERVENTION(S) WERE NEEDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2017693 ENDOWRIST STAPLER 30 RELOAD WHITE GDW INTUITIVE SURGICAL, INC 48630W-04 K10230926 0125 10886874112868

Patients

Seq Age Sex Outcome Treatment
1 72 YR Female DA VINCI INSTRUMENTS AND ACCESSORIES