FDA Adverse Event Other Summary report: N

TLS2 35C

MDR report key: 2925242 · Received January 17, 2013

Report

Report Number
1223422-2012-00006
Event Type
Other
Date Received
January 17, 2013
Report Date
January 14, 2013
Manufacturer
MICROLINE SURGICAL, INC
Product Code
GEI
PMA / PMN Number
K062257
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE TLS2 35C WAS NOT RETURNED IN A TIMELY MANNER, THEREFORE, NO INVESTIGATION COULD BE CONDUCTED.

Description of Event or Problem · 1

THE INSULATION TORE AFTER 10 MINUTES OF USE DURING ERAH SURGERY. NO TROCAR WAS USED, NO MECHANICAL STRESS ON THE RETRACTOR AND THE INSTRUMENT WAS USED IN A NORMAL MANNER. NO HARM TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
26779 TLS2 35C THERMAL LIGATING SHEARS GEI MICROLINE SURGICAL, INC 132-121D 206008

Patients

Seq Age Sex Outcome Treatment
1