FDA Adverse Event Injury Summary report: N

FLEXIBLE LOOP ELECTROSURGICAL ELECTRODE

MDR report key: 856164 · Received May 25, 2007

Report

Report Number
3004014191-2007-00001
Event Type
Injury
Date Received
May 25, 2007
Date of Event
April 30, 2007
Report Date
April 30, 2007
Manufacturer
RUBICOR MEDICAL, INC.
Product Code
GEI
PMA / PMN Number
K070275
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OK, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

THE PATIENT IS A FEMALE WITH INVASIVE DUCTAL CARCINOMA. DURING INSERTION OF THE FLEXIBLE LOOP ELECTROSURGICAL ELECTRODE IN 2007, AT 9:30AM, THE PHYSICIAN UNKNOWINGLY ENTERED THE PATIENT'S CHEST CAVITY WITH THE TIP OF THE DEVICE. USE OF THE DEVICE TO CUT SOFT TISSUE CONTINUED AS PLANNED. PRIOR TO CLOSURE, THE PHYSICIAN NOTED THE INJURY. THE PHYSICIAN CALLED THE CARDIOVASCULAR SURGEON FOR CONSULT. THE CARDIOVASCULAR SURGEON RECOMMENDED PLACING A LATERAL STITCH IN THE 1-CM INCISION. THE CARDIOVASCULAR SURGEON THEN PROCEEDED TO INSERT A DRAINAGE TUBE AND PLACED THE STITCH. THE PATIENT WAS RELEASED FROM THE HOSPITAL THE NEXT MONTH. THERE WAS NO EVIDENCE OF A DEVICE MALFUNCTION. THE DEVICE WAS DISPOSED OF AT THE CUSTOMER SITE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FLEXIBLE LOOP ELECTROSURGICAL ELECTRODE ELECTROSURGICAL ELECTRODE GEI RUBICOR MEDICAL, INC. 7000 07031702

Patients

Seq Age Sex Outcome Treatment
1 72 YR Hospitalization| R