FDA Adverse Event Other Summary report: N

VASCUCLEAR PRECISION BIPOLAR

MDR report key: 2913634 · Received January 7, 2013

Report

Report Number
1718850-2012-01122
Event Type
Other
Date Received
January 7, 2013
Report Date
December 11, 2012
Manufacturer
SORIN GROUP USA, INC.
Product Code
GEI
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE MFR DATE WILL BE PROVIDED WHEN THE LOT NUMBER IS REC¿D. SORIN GROUP REC¿D A REPORT THAT THE TIP OF THE ENDOSCOPIC VEIN HARVESTING BIPOLAR DEVICE BROKE OFF. SORIN GROUP HAS REQUESTED ADD¿L INFO REGARDING PT INVOLVEMENT AND STATUS. THIS INFO WILL BE PROVIDED WHEN IT IS REC¿D. THE INVESTIGATION IS ON-GOING. A F/U REPORT WILL BE SENT WHEN THE INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

SORIN GROUP REC¿D A REPORT THAT THE TIP OF THE ENDOSCOPIC VEIN HARVESTING BIPOLAR DEVICE BROKE OFF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
8909 VASCUCLEAR PRECISION BIPOLAR ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES GEI SORIN GROUP USA, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1