FDA Adverse Event Other Summary report: N

PLASMABLADE TISSUE DISSECTION DEVICE

MDR report key: 2573835 · Received May 9, 2012

Report

Report Number
3007069406-2012-00097
Event Type
Other
Date Received
May 9, 2012
Date of Event
September 7, 2011
Report Date
April 12, 2012
Manufacturer
MEDTRONIC ADVANCED ENERGY LLC
Product Code
GEI
PMA / PMN Number
K083415
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

PRODUCT WAS NOT AVAILABLE FOR EVALUATION BECAUSE THE COMPLAINT FILE WAS OPENED BASED ON THE REVIEW OF THE CLINICAL STUDY FILE. A REVIEW OF THE LHR DID NOT REVEAL ANY ISSUES DURING THE MANUFACTURING OF THIS LOT. END OF REPORT.

Description of Event or Problem · 1

PATIENT PARTICIPATING IN TONSILLECTOMY STUDY RECEIVED A TONSILLECTOMY ON (B)(6) 2011. ON (B)(6) 2011, PATIENT REPORTED NAUSEA AND VOMITING AND WAS PRESCRIBED ZOFRAN (INTERVENTION) FOR RELIEF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PLASMABLADE TISSUE DISSECTION DEVICE GEI MEDTRONIC ADVANCED ENERGY LLC PLASMABLADE TNA 35252

Patients

Seq Age Sex Outcome Treatment
1 UNK Other NOT AVAILABLE