FDA Adverse Event Other Summary report: N

COVATOR 20 WITH INTEGRATED CABLE ARTHROWAND

MDR report key: 2011836 · Received February 24, 2011

Report

Report Number
2951580-2011-00019
Event Type
Other
Date Received
February 24, 2011
Date of Event
January 20, 2011
Report Date
February 24, 2011
Manufacturer
ARTHROCARE CORP.
Product Code
GEI
PMA / PMN Number
K083306
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
DA
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

IT WAS REPORTED THAT THE DEVICE WILL BE RETURNED FOR INVESTIGATION. TO DATE THE DEVICE HAS NOT BEEN RECEIVED. A F/U REPORT WILL BE PROVIDED ONCE THE DEVICE INVESTIGATION AND LOT HISTORY REVIEW ARE COMPLETED.

Description of Event or Problem · 1

DURING A LABRUM REPAIR PROCEDURE USING A COVATOR 20 WITH INTEGRATED CABLE ARTHROWAND, A SMALL PIECE OF PLASTIC BROKE OFF THE ARTHROWAND. REPORTEDLY THE FRAGMENT WAS NOT FOUND OR REMOVED FROM THE PT. IT IS NOT KNOWN IF THE FRAGMENT REMAINS IN THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COVATOR 20 WITH INTEGRATED CABLE ARTHROWAND ELECTROSURGICAL CUTTING & COAGULATION DE GEI ARTHROCARE CORP. C432380-A

Patients

Seq Age Sex Outcome Treatment
1 22 YR Other