FDA Adverse Event Malfunction Summary report: N

QUANTUM2000 ELECTROSURG.

MDR report key: 4956089 · Received July 29, 2015

Report

Report Number
1216677-2015-00038
Event Type
Malfunction
Date Received
July 29, 2015
Date of Event
February 12, 2015
Report Date
May 19, 2015
Manufacturer
COOPERSURGICAL, INC.
Product Code
GEI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

COOPERSURGICAL, INC. IS CURRENTLY INVESTIGATING THE REPORTED COMPLAINT CONDITION. THE DEVICE INVOLVED IN THE COMPLAINT HAS BEEN RETURNED BY THE CUSTOMER FOR EVALUATION. ONCE THE INVESTIGATION IS COMPLETED A FOLLOW-UP REPORT WILL BE FILED.

Description of Event or Problem · 1

COOPERSURGICAL, INC. REPAIR LOG NUMBER (B)(4). A RETROSPECTIVE REVIEW OF THE REPORTED COMPLAINT CONDITION: "INADEQUATE CHARGE NOT CONSISTENTLY CUTTING OR CAUTERIZING". INDICATES A PRODUCT MALFUNCTION WHICH COULD POSSIBLY NECESSITATE INTERVENTION. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
493365 QUANTUM2000 ELECTROSURG. QUANTUM2000 GEI COOPERSURGICAL, INC. 909075

Patients

Seq Age Sex Outcome Treatment
1