FDA Adverse Event Injury Summary report: N

HARMONIC FOCUS* CURVED SHEARS, TORQUE WRENCH AND GRIP ASSIST

MDR report key: 2133929 · Received June 20, 2011

Report

Report Number
3005075853-2011-02502
Event Type
Injury
Date Received
June 20, 2011
Date of Event
June 1, 2011
Report Date
June 1, 2011
Manufacturer
ETHICON ENDO-SURGERY, LLC.
Product Code
LFL
PMA / PMN Number
K063192
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). INFORMATION NOT AVAILABLE, DEVICE NOT RETURNED FOR ANALYSIS.

Description of Event or Problem · 1

IT WAS REPORTED THAT POST-OP TO A THYROID PROCEDURE, REOPERATION WAS NECESSARY DUE TO BLEEDING. NO OTHER INFORMATION IS AVAILABLE AT THIS TIME. THE DEVICE WAS DISCARDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HARMONIC FOCUS* CURVED SHEARS, TORQUE WRENCH AND GRIP ASSIST INSTRUMENT, ULTRASONIC SURGICAL LFL ETHICON ENDO-SURGERY, LLC. UNK UNK

Patients

Seq Age Sex Outcome Treatment
1 GENERATOR AND HANDPIECE