FDA Adverse Event Other Summary report: N

PLASMABLADE TISSUE DISSECTION DEVICE

MDR report key: 2428908 · Received January 20, 2012

Report

Report Number
3007069406-2012-00022
Event Type
Other
Date Received
January 20, 2012
Report Date
August 24, 2010
Manufacturer
PEAK SURGICAL, INC.
Product Code
GEI
PMA / PMN Number
K083415
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4) 2012: THIS MDR IS BEING FILED BASED ON A RETROSPECTIVE REVIEW OF COMPLAINTS RECEIVED BY THE MFR. THE FACILITY DID NOT RETAIN THE DEVICE FOR EVAL, A FAILURE ANALYSIS OF THE COMPLAINT DEVICE COULD NOT BE COMPLETED. INVESTIGATION OF THE LOT HISTORY RECORD DID NOT NOTE ANY ISSUES DURING THE MFG OF THIS LOT. MALE PT, 5 TO 8 YEARS OF AGE, HAD A POST-OP BLEED 6 DAYS AFTER SURGERY. BLEEDING CONTROLLED IN PHYSICIAN'S OFFICE WITH SILVER NITRATE.

Description of Event or Problem · 1

INITIAL EVENT DESCRIPTION: PT HAD POST-OP BLEED 6 DAYS AFTER SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PLASMABLADE TISSUE DISSECTION DEVICE GEI PEAK SURGICAL, INC. PLASMABLADE TNA 28529

Patients

Seq Age Sex Outcome Treatment
1 Other NOT AVAILABLE