FDA Adverse Event Malfunction Summary report: N

LIGASURE ATLAS HANDSWITCHING 20CM

MDR report key: 3983220 · Received June 27, 2014

Report

Report Number
1717344-2014-00492
Event Type
Malfunction
Date Received
June 27, 2014
Date of Event
May 1, 2014
Report Date
June 4, 2014
Manufacturer
COVIDIEN LLP (SHANGHAI)
Product Code
GEI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). TO DATE THE INCIDENT SAMPLE HAS NOT BEEN RECEIVED FOR EVALUATION. IF THE SAMPLE IS RECEIVED OR IF ADDITIONAL INFO PERTINENT TO THE INCIDENT IS OBTAINED A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT DURING A PROCEDURE TO REMOVE THE HEAD OF THE PANCREAS, THE JAWS OF THE DEVICE WOULD NOT REOPEN WHILE APPLIED TO TISSUE. IT IS UNK HOW THE DEVICE WAS REMOVED FROM THE PT TISSUE. THERE WAS NO TISSUE DAMAGE OR UNANTICIPATED BLEEDING, AND NO HARM TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
378409 LIGASURE ATLAS HANDSWITCHING 20CM LIGASURE VESSEL SEALING SYS GEI COVIDIEN LLP (SHANGHAI) S3M002X

Patients

Seq Age Sex Outcome Treatment
1 UNK