FDA Adverse Event Death Summary report: N

ARGON BEAM COAGULATOR

MDR report key: 5649 · Received July 13, 1993

Report

Report Number
5649
Event Type
Death
Date Received
July 13, 1993
Date of Event
June 11, 1993
Report Date
June 15, 1993
Manufacturer
BIRTCHER
Product Code
HFG
Adverse Event
Yes
Report Source
User Facility report

Narratives

Description of Event or Problem · 1

WIEST GMBH OF BERLIN, GERMANY MANUFACTURED THE OLYMPUS CORP. SURGICAL CO2 INSUFFLATOR. ANOTHER UNIT WAS ALSO IN USE ON THIS PATIENT - BOTH UNITS HAVE BEEN SENT OUT FOR EVALUATION BY COUNSEL. ABOVE DESCRIBED DEVICES WERE USED IN LAPAROSCOPIC PROCEDURE. ALARM SOUNDED ON C02 INSUFFLATOR (INDICATING PRESSURE PROBLEM) DURING OR SHORTLY AFTER ARGON BEAM COAGULATOR USAGE. PATIENTS VITAL SIGNS DETERIORATED AND EVENTUALLY PATIENT ARRESTED. PATIENT DID NOT RESPOND TO RESUSCITATIVE PROCEDUREDEVICE NOT LABELED FOR SINGLE USE. PATIENT MEDICAL STATUS PRIOR TO EVENT: SATISFACTORY CONDITION. THERE WAS NOT MULTIPLE PATIENT INVOLVEMENT.DEVICE SERVICED IN ACCORDANCE WITH SERVICE SCHEDULE. DATE LAST SERVICED: 01-MAY-93. SERVICE PROVIDED BY: USER FACILITY BIOMEDICAL/BIOENGINEERING DEPARTMENT. SERVICE RECORDS AVAILABLE.NO IMMINENT HAZARD TO PUBLIC HEALTH CLAIMED. DEVICE USED AS LABELED/INTENDED.DEVICE WAS EVALUATED AFTER THE EVENT. METHOD OF EVALUATION: ACTUAL DEVICE INVOLVED IN INCIDENT WAS EVALUATED, PERFORMANCE TESTS PERFORMED. RESULTS OF EVALUATION: NONE OR UNKNOWN. CONCLUSION: NONE OR UNKNOWN. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: UNKNOWN (CANNOT DETERMINE). CORRECTIVE ACTIONS: DEVICE TEMPORARILY REMOVED FROM SERVICE. THE DEVICE WAS DESTROYED/DISPOSED OF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ARGON BEAM COAGULATOR BIRTCHER 6400 HFG BIRTCHER 13-2064-120

Patients

Seq Age Sex Outcome Treatment
1 50 YR Death