FDA Adverse Event Summary report: N

THE COAGULATOR

MDR report key: 4591 · Received April 2, 1993

Report

Report Number
4591
Date Received
April 2, 1993
Report Date
April 2, 1993
Manufacturer
INSTRUMENT MAKAR, INC.
Product Code
HQO
Report Source
User Facility report

Narratives

Description of Event or Problem · 1

PATIENT SCHEDULED FOR ARTHROSCOPIC LATERAL RETINACULAR RELEASE - RIGHT KNEE. PROCEDURE DONE WITH ELECTROCAUTERY UNIT. DOCTOR CONNECTED A HEMOSTAT TO CAUTERY TIP TO PREVENT THE TIP FROM TURNING INSIDE THE KNEE. THE INSULATION ON THE CAUTERY TIP WAS BROKEN AND THE HEMOSTAT CAME IN CONTACT WITH THE PATIENT'S SKIN, CAUSING IT TO CAUTERIZE THE TISSUE OF THE KNEE. PATIENT SUFFERED 2 CM FULL THICKNESS BURN @ ANTERMODIAL PORTAL. PATIENT TAKEN TAKEN TO RECOVERY ROOM IN SATISFACTORY CONDITION.INVALID DATA - REGARDING SINGLE USE LABELING OF DEVICE. PATIENT MEDICAL STATUS PRIOR TO EVENT: INVALID DATA. INVALID DATA - REGARDING MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY. INVALID DATA - REGARDING WHETHER EVENT PRESENTS IMMINENT HAZARD. INVALID DATA - WHETHER DEVICE USED AS LABELED/INTENDED. INVALID DATA - REGARDING EVALUATION BY USER AFTER EVENT. METHOD OF EVALUATION: INVALID DATA. RESULTS OF EVALUATION: INVALID DATA. CONCLUSION: INVALID DATA. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: INVALID DATA. CORRECTIVE ACTIONS: NO DATA. INVALID DATA - ON DEVICE DESTROYED/DISPOSED OF STATUS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 THE COAGULATOR HQO INSTRUMENT MAKAR, INC.

Patients

Seq Age Sex Outcome Treatment
1 Invalid Data