FDA Adverse Event Malfunction Summary report: N

LIGASURE IMPACT THORACIC

MDR report key: 3060633 · Received March 27, 2013

Report

Report Number
3006451981-2013-00076
Event Type
Malfunction
Date Received
March 27, 2013
Date of Event
February 18, 2013
Report Date
March 5, 2013
Manufacturer
COVIDIEN LLC (SHANGHAI)
Product Code
GEI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE RETURN OF THE INCIDENT SAMPLE HAS BEEN REQUESTED. TO DATE IT HAS NOT BEEN RECEIVED FOR EVAL. ADD'L QUESTIONS IN REGARD TO THE INCIDENT HAVE ALSO BEEN ASKED. IF THE SAMPLE IS RECEIVED OR IF ADD'L INFO PERTINENT TO THE INCIDENT IS OBTAINED, A F/U REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THE DEVICE JAWS COULD NOT BE RE-OPENED AND THAT THE DEVICE KNIFE WOULD NOT RETRACT. ADD'L CONTACT ATTEMPTS HAVE BEEN MADE TO THE CUSTOMER IN REGARD TO THE DEVICE AND INCIDENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
124892 LIGASURE IMPACT THORACIC LIGASURE VESSEL SEALING SYSTEM GEI COVIDIEN LLC (SHANGHAI) S2KF014X

Patients

Seq Age Sex Outcome Treatment
1 UNK