FDA Adverse Event Malfunction Summary report: N

LIGASURE IMPACT THORACIC

MDR report key: 2910630 · Received December 4, 2012

Report

Report Number
1717344-2012-01193
Event Type
Malfunction
Date Received
December 4, 2012
Date of Event
October 12, 2012
Report Date
November 28, 2012
Manufacturer
COVIDIEN LP
Product Code
GEI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE INCIDENT DEVICE HAS BEEN RECEIVED AND IS UNDER EVALUATION. WHEN THE DEVICE EVALUATION IS COMPLETE A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

THE CUSTOMER ORIGINALLY REPORTED THAT THE DEVICE ALARMED AND DID NOT FUNCTION PROPERLY. THERE WAS NO ACTIVATION FROM THE DEVICE. ANOTHER DEVICE WAS OPENED IN ORDER TO CONTINUE THE PROCEDURE. THERE WAS NO PATIENT INJURY. THE DEVICE WAS RETURNED FOR EVALUATION WITH THE KNIFE BLADE EXPOSED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LIGASURE IMPACT THORACIC LIGASURE VESSEL SEALING SYSTEM GEI COVIDIEN LP 218708LX

Patients

Seq Age Sex Outcome Treatment
1 UNK