FDA Adverse Event Injury Summary report: N

ATS 3000 TOURNIQUET

MDR report key: 2091657 · Received April 28, 2011

Report

Report Number
1526350-2011-00077
Event Type
Injury
Date Received
April 28, 2011
Date of Event
March 1, 2011
Report Date
March 30, 2011
Manufacturer
ZIMMER SURGICAL
Product Code
KCY
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS NOT RETURNED TO THE MFR AT THE TIME OF THIS REPORT. A F/U MEDWATCH WILL BE SUBMITTED ONCE THE DEVICE HAS BEEN RETURNED AND THE INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE ZIMMER ATS 3000 WAS USED IN A PROCEDURE WHERE THE SURGEON WAS REVISING A CLOSURE OF A LOWER EXTREMITY AMPUTATION. BLEEDING OCCURRED DURING THE PROCEDURE. THE TOURNIQUET WAS NOTED TO HAVE BEEN APPLIED TOO TIGHTLY PRIOR TO EXSANGUINATION OF LIMB.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ATS 3000 TOURNIQUET ATS 3000 TOURNIQUET KCY ZIMMER SURGICAL NA NA

Patients

Seq Age Sex Outcome Treatment
1