BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DI VANCI SURGICAL

    MDR report key: 4092954 · Received September 10, 2014

    Report

    Report Number
    MW5038170
    Event Type
    Malfunction
    Date Received
    September 10, 2014
    Date of Event
    August 15, 2014
    Report Date
    September 10, 2014
    Manufacturer
    INTUITIVE SURGICAL
    Product Code
    NAY
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    ROBOTIC SCISSOR PROTECTOR FRAYED/TORE AT THE END OF THE PROCEDURE. NO INJURY TO PATIENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    559681 DI VANCI SURGICAL ROBOTIC SCISSOR NAY INTUITIVE SURGICAL

    Patients

    Seq Age Sex Outcome Treatment
    1 44 YR