FDA Adverse Event Malfunction Summary report: N

LIGASURE ATLAS HANDSWITCHING 20CM

MDR report key: 2241570 · Received September 2, 2011

Report

Report Number
3006451981-2011-00124
Event Type
Malfunction
Date Received
September 2, 2011
Date of Event
August 17, 2011
Report Date
August 21, 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 RETURN OF THE INCIDENT SAMPLE HAS BEEN REQUESTED. TO DATE IT 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 300CC OF BLEEDING OCCURRED ALTHOUGH AN END TONE, INDICATING A COMPLETED SEAL CYCLE, WAS HEARD. THE DEVICE WAS USED TO COMPLETE THE PROCEDURE, THERE WAS NO TISSUE DAMAGE AND NO PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LIGASURE ATLAS HANDSWITCHING 20CM LIGASURE VESSEL SEALING SYSTEM GEI COVIDIEN LLC (SHANGHAI) S1B0004

Patients

Seq Age Sex Outcome Treatment
1 UNK