FDA Adverse Event Malfunction Summary report: N

LIGASURE ATLAS HANDSWITCHING 37CM

MDR report key: 2121461 · Received May 6, 2011

Report

Report Number
3006451981-2011-00074
Event Type
Malfunction
Date Received
May 6, 2011
Date of Event
April 26, 2011
Report Date
May 2, 2011
Manufacturer
COVIDIEN LLC (SHANGHAI)
Product Code
GEI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE INCIDENT SAMPLE HAS BEEN REQUESTED BUT TO DATE HAS NOT BEEN RECEIVED FOR EVAL. IF THE SAMPLE IS RECEIVED OR IF ADD'L INFO PERTINENT TO THE INCIDENT IS OBTAINED, A F/U REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT DURING A LADG PROCEDURE WITH THE FORCETRIAD SET AT 2 BARS, OOZING OCCURRED FROM THE GREATER OMENTUM EVEN THOUGH AN END TONE, INDICATING A COMPLETED SEAL CYCLE, WAS HEARD. THIS OOZING OCCURRED AGAIN WHEN THE GENERATOR WAS INCREASED TO 3 BARS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LIGASURE ATLAS HANDSWITCHING 37CM LIGASURE VESSEL SEALING SYSTEM GEI COVIDIEN LLC (SHANGHAI) S1A0006

Patients

Seq Age Sex Outcome Treatment
1 UNK FORCETRIAD - ENERGY PLATFORM - S/N UNK