FDA Adverse Event Malfunction Summary report: N

CONMED

MDR report key: 22094820 · Received May 28, 2025

Report

Report Number
1320894-2025-00142
Event Type
Malfunction
Date Received
May 28, 2025
Date of Event
April 30, 2025
Report Date
September 11, 2025
Manufacturer
CONMED UTICA
Product Code
HFG
UDI-DI
30653405009768
PMA / PMN Number
K904240
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

NEITHER THE DEVICE NOR PHOTOGRAPHIC EVIDENCE WAS PROVIDED. THEREFORE, THE REPORTED EVENT CANNOT BE VERIFIED. THE MANUFACTURING DOCUMENTS FROM THE DEVICE HISTORY RECORD HAVE BEEN REVIEWED WITH SPECIAL ATTENTION TO THE MANUFACTURING AND INSPECTION OF THE PRODUCT. THE PRODUCT RELEASED FOR DISTRIBUTION WAS FOUND TO HAVE MET ALL SPECIFICATIONS PRIOR TO SHIPMENT. THIS IS THE ONLY COMPLAINT FOR THIS LOT NUMBER AND FAILURE MODE WITHIN THE PAST TWO YEARS. (B)(4). PER THE INSTRUCTIONS FOR USE, THE USER IS ADVISED TO INSPECT THE INSULATION ON THE INSTRUMENT SHAFT. DO NOT USE AN INSTRUMENT OR ELECTRODE IF THE INSULATION IS CRACKED, OR DAMAGED. THIS PRODUCT IS DESIGNED FOR NON-CONTINUOUS OPERATION, WITH A DUTY CYCLE OF 10 SECONDS ON, AND 30 SECONDS OFF. WE WILL CONTINUE TO MONITOR PER REGULATORY REQUIREMENTS TO HELP ENSURE PATIENT SAFETY.

Additional Manufacturer Narrative · 0

THE REPORTED DEVICE IS BEING RETURNED TO CONMED FOR EVALUATION. A SUPPLEMENTAL AND FINAL REPORT WILL BE FILED FOLLOWING THE COMPLETION OF THE DEVICE EVALUATION AND COMPLAINT INVESTIGATION. WE WILL CONTINUE TO MONITOR PER REGULATORY REQUIREMENTS TO HELP ENSURE PATIENT SAFETY.

Additional Manufacturer Narrative · 0

UPDATE: RETURNED DEVICE EVALUATION HAS BEEN ADDED TO MANUFACTURER NARRATIVE. MANUFACTURER NARRATIVE: AN EXAMINATION OF RETURNED USED 60-5163-001 DEVICE FOUND THAT THE MOLDED PLASTIC COVERING THE ROD WAS MELTED AND DEFORMED. ROOT CAUSE CANNOT BE DETERMINED, HOWEVER, BASED UPON THE IFU; A POSSIBLE CAUSE OF THIS EVENT COULD BE THAT THE ELECTRODE INSULATION IS CRACKED, OR DAMAGED. THE MANUFACTURING DOCUMENTS FROM THE DEVICE HISTORY RECORD HAVE BEEN REVIEWED WITH SPECIAL ATTENTION TO THE MANUFACTURING AND INSPECTION OF THE PRODUCT. THE PRODUCT RELEASED FOR DISTRIBUTION WAS FOUND TO HAVE MET ALL SPECIFICATIONS PRIOR TO SHIPMENT. THIS IS THE ONLY COMPLAINT FOR THIS LOT NUMBER AND FAILURE MODE WITHIN THE PAST TWO YEARS. A TWO-YEAR REVIEW OF COMPLAINT HISTORY REVEALED THERE HAS BEEN A TOTAL OF 7 COMPLAINTS, REGARDING 7 DEVICES, FOR THIS DEVICE FAMILY AND FAILURE MODE. DURING THIS SAME TIME FRAME (B)(4) DEVICES HAVE BEEN MANUFACTURED AND SHIPPED WORLDWIDE. SHOULD ALL THE COMPLAINT DEVICES HAVE BEEN FOUND CONFIRMED FOR THIS REPORTED FAILURE, THE RATE OF FAILURE WOULD BE (B)(4). PER THE INSTRUCTIONS FOR USE, THE USER IS ADVISED TO INSPECT THE INSULATION ON THE INSTRUMENT SHAFT. DO NOT USE AN INSTRUMENT OR ELECTRODE IF THE INSULATION IS CRACKED, OR DAMAGED. THIS PRODUCT IS DESIGNED FOR NON-CONTINUOUS OPERATION, WITH A DUTY CYCLE OF 10 SECONDS ON, AND 30 SECONDS OFF. WE WILL CONTINUE TO MONITOR PER REGULATORY REQUIREMENTS TO HELP ENSURE PATIENT SAFETY.

Description of Event or Problem · 0

THE SALES REPRESENTATIVE REPORTED ON BEHALF OF THE CUSTOMER THAT THE DEVICE, 60-5163-001, LAPAROSCOPIC ELECTRODE WITH A 3/32" PIN CONNECTOR, L-HOOK, WAS BEING USED DURING AN OPEN PROCEDURE ON (B)(6) 2025 WHEN IT WAS REPORTED, ¿SING L-HOOK (SETTINGS AT 30CUT 30COAG BLEND) STAFF NOTICED SOME OF THE BLACK PLASTIC PART OF THE DEVICE HAD MELTED OFF IN BODY. MELTED PIECE AND L-HOOK REMOVED FROM BODY AND TAKEN OUT OF CIRCULATION.¿. THERE WAS NO REPORT OF INJURY, MEDICAL INTERVENTION, OR HOSPITALIZATION FOR THE PATIENT OR USER. THIS REPORT IS BEING RAISED DUE TO THE REPORTED MALFUNCTION WITH POTENTIAL FOR INJURY UPON REOCCURRENCE.

Description of Event or Problem · 0

THE SALES REPRESENTATIVE REPORTED ON BEHALF OF THE CUSTOMER THAT THE DEVICE, 60-5163-001, LAPAROSCOPIC ELECTRODE WITH A 3/32" PIN CONNECTOR, L-HOOK, WAS BEING USED DURING AN OPEN PROCEDURE ON 30APR25 WHEN IT WAS REPORTED, ¿SING L-HOOK (SETTINGS AT 30CUT 30COAG BLEND) STAFF NOTICED SOME OF THE BLACK PLASTIC PART OF THE DEVICE HAD MELTED OFF IN BODY. MELTED PIECE AND L-HOOK REMOVED FROM BODY AND TAKEN OUT OF CIRCULATION.¿. THERE WAS NO REPORT OF INJURY, MEDICAL INTERVENTION, OR HOSPITALIZATION FOR THE PATIENT OR USER. THIS REPORT IS BEING RAISED DUE TO THE REPORTED MALFUNCTION WITH POTENTIAL FOR INJURY UPON REOCCURRENCE.

Description of Event or Problem · 0

THE SALES REPRESENTATIVE REPORTED ON BEHALF OF THE CUSTOMER THAT THE DEVICE, 60-5163-001, LAPAROSCOPIC ELECTRODE WITH A 3/32" PIN CONNECTOR, L-HOOK, WAS BEING USED DURING AN OPEN PROCEDURE ON (B)(6) 2025 WHEN IT WAS REPORTED, ¿SING L-HOOK (SETTINGS AT 30CUT 30COAG BLEND) STAFF NOTICED SOME OF THE BLACK PLASTIC PART OF THE DEVICE HAD MELTED OFF IN BODY. MELTED PIECE AND L-HOOK REMOVED FROM BODY AND TAKEN OUT OF CIRCULATION.¿. THERE WAS NO REPORT OF INJURY, MEDICAL INTERVENTION, OR HOSPITALIZATION FOR THE PATIENT OR USER. THIS REPORT IS BEING RAISED DUE TO THE REPORTED MALFUNCTION WITH POTENTIAL FOR INJURY UPON REOCCURRENCE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1014440 CONMED COAGULATOR, LAPAROSCOPIC, UNIPOLAR (AND ACCESSORIES) HFG CONMED UTICA 202404151 30653405009768

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown