FDA Adverse Event Malfunction Summary report: N

PULSAR GENERATOR

MDR report key: 2821336 · Received October 25, 2012

Report

Report Number
3007069406-2012-00357
Event Type
Malfunction
Date Received
October 25, 2012
Report Date
February 7, 2012
Manufacturer
MEDTRONIC ADVANCED ENERGY LLC
Product Code
GEI
PMA / PMN Number
K082786
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS MDR IS BEING FILED BASED ON A RETROSPECTIVE REVIEW OF COMPLAINTS RECEIVED BY THE MANUFACTURER FOR THE TIME PERIOD (B)(4) 2010 THROUGH (B)(4) 2012. THE REPRESENTATIVE INFORMED MEDTRONIC THE UNIT WOULD BE RETURNED; HOWEVER, AS OF (B)(4) 2012, THE UNIT HAS NOT BEEN RETURNED. IF THE GENERATOR IS RETURNED, A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THE COAGULATION WAS WEAK AND THERE WAS A LOUD NOISE. THERE WERE NO PATIENT CONSEQUENCES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PULSAR GENERATOR GEI MEDTRONIC ADVANCED ENERGY LLC PULSAR II UNK

Patients

Seq Age Sex Outcome Treatment
1 NI PLASMABLADE