FDA Adverse Event
Malfunction
Summary report: N
BURN PK
MDR report key: 19459083
·
Received June 4, 2024
Report
- Report Number
- 1423395-2024-00423
- Event Type
- Malfunction
- Date Received
- June 4, 2024
- Date of Event
- April 22, 2024
- Report Date
- June 4, 2024
- Manufacturer
- MEDLINE INDUSTRIES LP
- Product Code
- OJJ
- UDI-DI
- 10195327443856
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NC, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 0
IT WAS REPORTED THAT THE BOVIE TIP SPARKED. THERE WAS NO INJURY REPORTED AND THE PROCEDURE WAS COMPLETED. IT HAS BEEN DETERMINED THAT THE REPORTED EVENT COULD CAUSE OR CONTRIBUTE TO SERIOUS INJURY IF IT WERE TO OCCUR. IN AN ABUNDANCE OF CAUTION, THIS MEDWATCH IS BEING FILED. IF ANY FURTHER RELEVANT INFORMATION IS IDENTIFIED OR OBTAINED, A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED.
Description of Event or Problem · 0
"BOVIE HAD A LARGE SPARK"
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 150065 | BURN PK | OJJ | MEDLINE INDUSTRIES LP | 10195327443856 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 52 YR | Male | Other |