FDA Adverse Event Malfunction Summary report: N

LIGASURE ATLAS HANDSWITCHING 37CM

MDR report key: 2222431 · Received July 14, 2011

Report

Report Number
3006451981-2011-00091
Event Type
Malfunction
Date Received
July 14, 2011
Date of Event
June 20, 2011
Report Date
June 22, 2011
Manufacturer
COVIDIEN LLC (SHANGHAI)
Product Code
GEI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE SAMPLE HAS BEEN REQUESTED BUT TO DATE THE INCIDENT SAMPLE HAS NOT BEEN RECEIVED FOR EVALUATION. IF THE SAMPLE IS RECEIVED OR IF ADDITIONAL INFORMATION PERTINENT TO THE INCIDENT IS OBTAINED A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT AFTER THE FIRST SEAL, THE JAWS WOULD NOT RELEASE THE CAUTERIZED TISSUE. THE DEVICE WAS EXCISED FROM TISSUE. ANOTHER DEVICE WAS USED TO COMPLETE THE PROCEDURE W/O INCIDENT. THERE WAS NO TISSUE DAMAGE, NO BLOOD LOSS AND NO PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LIGASURE ATLAS HANDSWITCHING 37CM LIGASURE VESSEL SEALING SYSTEM GEI COVIDIEN LLC (SHANGHAI) S0L0010P

Patients

Seq Age Sex Outcome Treatment
1 UNK