FDA Adverse Event
Other
Summary report: N
VAPORIZATION RESECTOTRODE
MDR report key: 2163647
·
Received June 10, 2011
Report
- Report Number
- 3006159227-2011-00004
- Event Type
- Other
- Date Received
- June 10, 2011
- Date of Event
- May 11, 2011
- Report Date
- June 10, 2011
- Manufacturer
- GYRUS ACMI, INC.
- Product Code
- FAS
- PMA / PMN Number
- K973820
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
AT THE TIME OF THIS REPORT, MULTIPLE ATTEMPTS TO OBTAIN FURTHER INFO FROM THE HOSPITAL HAVE BEEN UNSUCCESSFUL, AND THE DEVICE HAS NOT YET BEEN RETURNED FOR EVALUATION. AS A RESULT, A DETERMINATION CANNOT BE MADE AT THIS TIME. IF FURTHER INFO BECOMES AVAILABLE, GYRUS ACMI WILL CONTINUE THE INVESTIGATION AND UPDATE THE AGENCY ACCORDINGLY.
Description of Event or Problem · 1
A TRANSURETHRAL ELECTRO-RESECTION OF THE PROSTATE PROCEDURE WAS BEING PERFORMED WITH THE ROLERBALL VAPORIZATION, USING THE WORKING ELEMENT, RESEC TRODE, AND ACTIVE CORD. INTRO-OPERATIVELY, THE SURGEON EXPERIENCED A SHOCK AND SPARKS WERE SEEN BY THE SURGEON ON THE BACK END OF THE SCOPE. NO BURNS WERE EXPERIENCED BY THE PT OR THE SURGEON. CROSS-REFERENCE MEDWATCH #1519132-2011-00014 AND 1519132-2011-00015.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | VAPORIZATION RESECTOTRODE | VAPORIZATION RESECTOTRODE | FAS | GYRUS ACMI, INC. | VE-RT |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |