FDA Adverse Event Malfunction Summary report: N

ECHELON*FLEX60 ARTICULATING ENDOSCOPIC LINEAR CUTTER, 60 MM

MDR report key: 3062999 · Received April 17, 2013

Report

Report Number
3005075853-2013-01838
Event Type
Malfunction
Date Received
April 17, 2013
Date of Event
March 4, 2013
Report Date
March 28, 2013
Manufacturer
ETHICON ENDO-SURGERY, LLC.
Product Code
GDW
PMA / PMN Number
K081146
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AU
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). SHOULD THE INFORMATION BE PROVIDED LATER, A SUPPLEMENTAL MEDWATCH WILL BE SENT. THE DEVICE WAS RECEIVED FOR ANALYSIS WITH NO VISUAL NON-CONFORMANCES AND WITH AN ECR60B CARTRIDGE RELOAD LOADED IN THE DEVICE. THE CARTRIDGE RELOAD WAS RECEIVED PARTIALLY FIRED 1/10. IT IS POSSIBLE THAT WHILE LOADING THE RELOAD, THE CARTRIDGE WAS PUSHED FARTHER BACK THAN THE CARTRIDGE ALIGNMENT STOP WINDOWS RESULTING IN THE KNIFE PUSHING THE ONE PIECE SLED FORWARD AND LOCKING THE CARTRIDGE. IT SHOULD BE NOTED THAT IN ORDER TO OPEN A DEVICE THAT HAS BEING PARTIALLY FIRED OR FULLY FIRED A REVERSE STROKE NEEDS TO BE PERFORMED TRIGGER TO TRIGGER TO HANDLE IN ORDER TO RETURN THE KNIFE TO THE HOME POSITION (INDICATOR IN THE "0" POSITION) AND PRESS THE ANVIL RELEASE BUTTON TO OPEN. THE RETURNED DEVICE AND CARTRIDGE RELOAD WERE TESTED FOR FUNCTIONALITY IN THE ARTICULATED POSITION BY RESETTING AND RELOADING IT INTO THE DEVICE. THE DEVICE ACHIEVED ITS COMPLETE STROKE FIRING SEQUENCE WITHOUT ANY DIFFICULTIES. THE STAPLE LINE AND CUT LINE WERE COMPLETE AND THE STAPLES WERE NOTED TO HAVE THE PROPER B-FORM SHAPE. THE EVENT COULD NOT BE CONFIRMED AS THE DEVICE CLOSED AND OPENED AS INTENDED.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A LAPAROSCOPIC SIGMA PROCEDURE THE RELOAD WAS INSERTED - DEVICE WAS CLOSED - IT WASN´T POSSIBLE TO OPEN IT. A NEW DEVICE WAS OPENED AND THE SURGERY FINISHED. NO CONSEQUENCES FOR THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
166078 ECHELON*FLEX60 ARTICULATING ENDOSCOPIC LINEAR CUTTER, 60 MM STAPLE, IMPLANTABLE GDW ETHICON ENDO-SURGERY, LLC. UNK J4CM3A

Patients

Seq Age Sex Outcome Treatment
1