SPIDER SURGICAL PLATFORM 9000020 G2L 9000041

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2012-06-08 for SPIDER SURGICAL PLATFORM 9000020 G2L 9000041 manufactured by Transenterix Inc..

Event Text Entries

[18277940] During a laparoscopic procedure, the surgeon reported a loss of responsiveness with the device due to a loose wire. The unit was returned 30 days after the event was reported and during the evaluation of the unit, it was determined that the wire had broken. No injury or impact to patient care was reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3007593944-2012-00005
MDR Report Key2613392
Report Source05
Date Received2012-06-08
Date of Report2012-06-08
Date of Event2012-04-07
Date Mfgr Received2012-05-07
Device Manufacturer Date2012-01-01
Date Added to Maude2012-10-09
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMS TAMMY CARREA, VP
Manufacturer Street635 DAVIS DRIVE STE 300
Manufacturer CityMORRISVILLE NC 27560
Manufacturer CountryUS
Manufacturer Postal27560
Manufacturer Phone9197658420
Manufacturer Street2933 SOUTH MIAMI STE 119
Manufacturer CityDURHAM NC 27703
Manufacturer CountryUS
Manufacturer Postal Code27703
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSPIDER SURGICAL PLATFORM
Generic NameOTJ, LAPAROSCOPIC SINGLE PORT ACCESS
Product CodeOTJ
Date Received2012-06-08
Returned To Mfg2012-05-07
Model Number9000020 G2L
Catalog Number9000041
Lot NumberTX017121
ID NumberNA
Device Expiration Date2013-12-31
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerTRANSENTERIX INC.
Manufacturer AddressDURHAM NC US


Patients

Patient NumberTreatmentOutcomeDate
10 2012-06-08

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