FDA Adverse Event Other Summary report: N

LIGASURE V SEALER/DIVIDER

MDR report key: 2763032 · Received September 19, 2012

Report

Report Number
3006451981-2012-00145
Event Type
Other
Date Received
September 19, 2012
Date of Event
August 27, 2012
Report Date
August 29, 2012
Manufacturer
COVIDIEN LLC (SHANGHAI)
Product Code
GEI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
NURSE

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 BLEEDING OCCURRED ALTHOUGH AN END TONE, INDICATING A COMPLETED SEAL CYCLE, WAS HEARD. THERE WERE ABLE TO USE THE DEVICE TO STOP THE BLEEDING. ANOTHER DEVICE WAS USED TO COMPLETE THE PROCEDURE WITHOUT INCIDENT. THERE WAS NO PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LIGASURE V SEALER/DIVIDER LIGASURE VESSEL SEALING SYSTEM GEI COVIDIEN LLC (SHANGHAI) S1MB868X

Patients

Seq Age Sex Outcome Treatment
1 UNK