FDA Adverse Event Injury Summary report: N

ENDOWRIST

MDR report key: 20501883 · Received October 22, 2024

Report

Report Number
2955842-2024-20881
Event Type
Injury
Date Received
October 22, 2024
Date of Event
September 24, 2024
Report Date
September 24, 2024
Manufacturer
INTUITIVE SURGICAL, INC
Product Code
NAY
UDI-DI
00886874119808
PMA / PMN Number
K214095
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

NO PRODUCT HAS BEEN RETURNED TO INTUITIVE SURGICAL, INC. (ISI) FOR FAILURE ANALYSIS EVALUATION. A SYSTEM LOG REVIEW DID NOT REVEAL ANY SYSTEM ERRORS THAT WOULD HAVE CAUSED OR CONTRIBUTED TO THE REPORTED EVENT.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED LEFT PARTIAL NEPHRECTOMY, THE PROCEDURE WAS CONVERTED TO OPEN DUE TO UNCONTROLLABLE BLEEDING AND THE PATIENT'S DIFFICULT ACCESS TO THE "RETRO VEIN." AFTER DISSECTING THE RENAL PEDICLE TO SECURE THE ARTERIES, THE LEFT POLAR ARTERY WAS SEVERED FLUSH WITH THE AORTA. ONCE THE INJURY OCCURRED, THE ARTERY WAS CLAMPED AND THE OTHER INSTRUMENTS WERE REMOVED SO THE SYSTEM COULD BE UNDOCKED, AND THE INCISION WAS MODIFIED TO CONVERT THE PROCEDURE TO OPEN. ONCE CONVERTED, THE AREA WAS MARKED, AND THE SURGEON DISSECTED AROUND THE BIPOLAR INSTRUMENT THAT BEING USED AS A CLAMP. A HEM-O-LOC CLIP WAS PLACED FLUSH WITH THE AORTA AND THE BIPOLAR INSTRUMENT WAS REMOVED MANUALLY. TO COMPLETE THE REPAIR THE VASCULAR SURGEON PLACED TWO "X- STITCHES" ON THE AORTIC WOUND. THE PATIENT LOST 800 CC OF BLOOD DURING THE PROCEDURE, 650 CC OF THAT WAS FROM THE ARTERIAL WOUND, AND THE PATIENT RECEIVED 2 UNITS OF BLOOD. WHEN ASKED WHAT ABOUT THE PATIENT'S ANATOMY PROMPTED THE CONVERSION, THE SURGEON SAID THE UNCONTROLLABLE BLEEDING AND THE PATIENT'S ACCESS TO THE "RETRO VEIN" WAS DIFFICULT. THERE WAS NOTHING IN THE PATIENT'S PREOPERATIVE ASSESSMENT OR MEDICAL HISTORY CAUSING THE SURGEON TO ANTICIPATE THE CONVERSION. THE PATIENT WAS HOSPITALIZED FOR 4 DAYS PAST THE STANDARD FOR THE PROCEDURE (6 AS OPPOSED TO 2), BUT THE SURGEON IS NOT CONCERNED ABOUT LONG TERM COMPLICATIONS. DEVICE EVALUATION: THE PRODUCT WAS RETURNED TO INTUITIVE SURGICAL, INC. (ISI) AND FAILURE ANALYSIS (FA) CONFIRMED BUT DID NOT REPLICATE THE CUSTOMER REPORTED COMPLAINT. THE INSTRUMENT UNDERWENT INTERNAL AND EXTERNAL INSPECTION, NO ISSUES WERE DETECTED AND FA COULD NOT VERIFY THE CUSTOMER REPORTED EVENT. THE INSTRUMENT WAS TESTED ON AN IN-HOUSE SYSTEM AND PASSED THE RECOGNITION AND ENGAGEMENT TESTS. THE INSTRUMENT MOVED INTUITIVELY WITH FULL RANGE OF MOTION IN ALL DIRECTIONS, THE GRIP TIPS OPENED AND CLOSED PROPERLY, AND THE INSTRUMENT PASSED ENERGY DELIVERY TESTING IN VARIOUS GRIP ORIENTATIONS. THE INSTRUMENT ALSO PASSED THE ELECTRICAL CONTINUITY TEST. THE INSTRUMENT WAS FULLY FUNCTIONAL, AND NO PRODUCT ISSUE WAS FOUND. THE ERROR LOGS INDICATE THE PRESENCE OF AN ERROR CODE CONFIRMING THAT THE INSTRUMENT RELEASE KIT WAS UTILIZED TO REMOVE THE INSTRUMENT FROM THE SYSTEM.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED PARTIAL NEPHRECTOMY, THE PROCEDURE WAS CONVERTED TO OPEN SURGERY DUE TO PATIENT ANATOMY AND SURGEON PREFERENCE. THE FENESTRATED BIPOLAR FORCEPS INSTRUMENT WAS USED AS A CLAMP ON AN ARTERY DURING THE CONVERSION. THE INSTRUMENT WAS SUBSEQUENTLY MANUALLY RELEASED. THOUGH IT WAS STATED PATIENT ANATOMY AND SURGEON PREFERENCE WAS THE REASON FOR THE CONVERSION, IT IS UNCLEAR WHAT OCCURRED THAT CREATED A NEED FOR THE INSTRUMENT TO BE USED AS A CLAMP ON THE ARTERY.

Description of Event or Problem · 0

REFER TO H10/H11 FOR FOLLOW-UP INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
293842 ENDOWRIST FENESTRATED BIPOLAR FORCEPS NAY INTUITIVE SURGICAL, INC 471205-17 K14240327 0078 00886874119808

Patients

Seq Age Sex Outcome Treatment
1 87 YR Male Required Intervention| H DA VINCI INSTRUMENTS AND ACCESSORIES