FDA Adverse Event Malfunction Summary report: N

CUSA EXCEL CONSOLE 110V AC WITH FOOTSWITCH

MDR report key: 2971099 · Received February 1, 2013

Report

Report Number
3006697299-2013-00011
Event Type
Malfunction
Date Received
February 1, 2013
Date of Event
January 23, 2013
Report Date
February 1, 2013
Manufacturer
INTEGRA LIFESCIENCES (IRELAND) LIMITED
Product Code
LFL
PMA / PMN Number
K981262
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TO DATE, THE DEVICE INVOLVED IN THE REPORTED INCIDENT HAS NOT BEEN RECEIVED FOR EVALUATION. AN INVESTIGATION HAS BEEN INITIATED BASED ON THE REPORTED INFORMATION.

Description of Event or Problem · 1

THE FIRST OF TWO REPORTS FROM THE SAME FACILITY INVOLVING THE SAME PRODUCT, DIFFERENT SERIAL NUMBER. INITIALLY CUSA CONSOLES AND 2 CUSA HANDPIECES WERE REPORTED AS HAVING "NO CAVITATION'. THE HOSPITAL STAFF REPORTED THAT "THE AMPLITUDE WAS DROPPING BACK TO 10% AND NOT FUNCTIONING AS EXPECTED AND THAT IT WAS A "PARTICULARLY TOUGH TUMOUR". A CURVED EXTENDED TIP WAS USED FOR THE SURGERY. THE PATIENT WAS NOT INJURED, HOWEVER IT CAUSED A DELAY OF AT LEAST 15 MINUTES. THE PATIENT DID HAVE A 'VERY HARD TUMOR' AND THE DID HAVE TROUBLE REMOVING THE TUMOR WITH THE CUSA RESULTING IN VARIOUS TIPS BEING USED (ONE WAS THE C4611S). (UNABLE TO GET INFORMATION ABOUT WHICH OTHER CUSA TIPS WERE USED). THE SURGEON USED ANOTHER MANUFACTURER'S PRODUCT. THE OUTCOME OF REMOVING THE TUMOR WITH THE OTHER PRODUCT WAS UNKNOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
45326 CUSA EXCEL CONSOLE 110V AC WITH FOOTSWITCH ULTRASONIC SURGICAL PRODUCTS LFL INTEGRA LIFESCIENCES (IRELAND) LIMITED

Patients

Seq Age Sex Outcome Treatment
1 49 YR