FDA Adverse Event Malfunction Summary report: N

ENSEAL G2 ARTICULATING

MDR report key: 3896440 · Received June 26, 2014

Report

Report Number
3005075853-2014-04422
Event Type
Malfunction
Date Received
June 26, 2014
Date of Event
June 12, 2014
Report Date
June 16, 2014
Manufacturer
ETHICON ENDO-SURGERY, LLC.
Product Code
GEI
PMA / PMN Number
K122797
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). INFORMATION ANTICIPATED, BUT UNAVAILABLE AT THIS TIME. NO DEVICE RECEIVED FOR ANALYSIS AT TIME OF SUBMISSION OF 3500A. WHEN ADDITIONAL INFORMATION IS RECEIVED AND/OR THE DEVICE ANALYSIS HAS BEEN COMPLETED, A SUPPLEMENTAL MEDWATCH WILL BE SENT.

Additional Manufacturer Narrative · 1

(B)(4). ADDITIONAL INFORMATION THE DEVICE WAS RECEIVED IN GOOD PHYSICAL CONDITION. THE DEVICE WAS TESTED ON THE GENERATOR AND PASSED ALL FUNCTIONAL TESTING. THE ENERGY OUTPUT DELIVERED FROM THE DEVICE WAS VERIFIED AND THE CUTTING OF THE TEST MEDIA PERFORMED AS EXPECTED. ALL THREE TONES WERE HEARD DURING FUNCTIONAL TESTING (TONE 1 IS HEARD WHEN THE ENERGY ACTIVATION BUTTON IS PRESSED; TONE 2 IS HEARD WHEN TISSUE IMPEDANCE THRESHOLD IS REACHED; AND TONE 3 IS HEARD WHEN THE CYCLE IS COMPLETE). NO ISSUES WERE NOTED WITH OPENING AND CLOSING OF THE JAWS. THERE WERE NO ANOMALIES NOTED WITH THE FUNCTIONALITY OF THE DEVICE. THIS REPORT IS NOT INTENDED TO DENY THAT YOU EXPERIENCED A PROBLEM WITH THE DEVICE. THERE MAY HAVE BEEN OTHER CIRCUMSTANCES OR ISSUES THAT OCCURRED DURING THE USE OF THE DEVICE THAT WE WERE UNABLE TO DUPLICATE DURING OUR LABORATORY ANALYSIS.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A TLH PROCEDURE, THE JAWS ON A DEVICE KEPT GETTING STUCK IN THE CLOSED POSITION. THE JAWS WERE NOT ON VESSELS/ARTERIES WHEN THEY WERE STUCK IN THE CLOSED POSITION, AND WERE ABLE TO BE MANUALLY FORCED OPEN. THE PROCEDURE WAS COMPLETED USING ANOTHER DEVICE AND THERE WERE NO CONSEQUENCES TO THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
374893 ENSEAL G2 ARTICULATING . GEI ETHICON ENDO-SURGERY, LLC. NA K4DL65

Patients

Seq Age Sex Outcome Treatment
1 GENERATOR