MAUDE MDR 1317629

MDR report key
1317629
Report number
1317629
Event key
0
Event type
3
Date of event
2009-01-23
Date received
2009-02-11
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
500
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Report source
U
Manufacturer link flag
N

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1HYDRO-SURG PLUSIRRIGATOR, LAPAROSCOPIC, BATTERY POWEREDDAVOL INC.KQT*0026880JUSDF003 Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12009-02-110

Event Narratives#

D

Patient 1

IRRIGATOR WAS LEAKING WATER FROM THE BATTERY PACK COMPARTMENT. THIS WAS THE SECOND OCCURRENCE IN A ROW. THE STAFF ONLY RETAINED ONE OF THE TWO IRRIGATORS THAT LEAKED.