FDA Adverse Event Injury Summary report: N

BOVIE MEDICAL CORPORATION

MDR report key: 3703779 · Received March 5, 2014

Report

Report Number
3007593903-2014-00001
Event Type
Injury
Date Received
March 5, 2014
Date of Event
January 14, 2014
Report Date
February 5, 2014
Manufacturer
BOVIE MEDICAL CORPORATION
Product Code
GEI
PMA / PMN Number
K000961
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE POWER SETTING ON THE UNIT IN THE AS REC'D CONDITION WAS AT 12 WATTS. THE DEVICE AND THE CUSTOMER PROVIDED GROUNDING PLATE (A802EU) AND POWER CORD WAS TESTED IN THE REC'D STATE PER BOVIE PROCEDURE QA-354. THE UNIT MET ALL TEST REQUIREMENTS WITH NO ISSUES OR ANOMALIES SEEN. THE CUSTOMER CONFIRMED THAT CONDUCTIVE GEL WAS NOT USED AND HAD NEVER BEEN USED.

Description of Event or Problem · 1

DURING A DENTAL PROCEDURE USING THE DESICCATOR (SAME SETUP) AND GROUNDING PLATE, TWO PTS REC'D BURNS (SECOND DEGREE) UNDER THE PLATE. THE GROUNDING PLATE WAS PLACED ON THE PT'S STOMACH W/O THE USE OF CONDUCTIVE GEL. NO INTERVENTION WAS REQUIRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
134112 BOVIE MEDICAL CORPORATION ELECTROSURGICAL DESICCATOR GEI BOVIE MEDICAL CORPORATION A940

Patients

Seq Age Sex Outcome Treatment
1 Other A802EU GROUNDING PLATE WITH CORD