MAUDE MDR 2804100

MDR report key
2804100
Report number
3006159227-2012-00011
Event key
0
Event type
3
Date of event
2012-10-03
Date received
2012-10-22
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
TERRENCE SULLIVAN
Address
136 TURNPIKE RD. SOUTHBOROUGH MA 01772 US
Phone
508-508-5088
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1CUTTING LOOPCUTTING LOOPGYRUS ACMI, INC.CBNMLE-26-012MLE-26-012361427R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12012-10-220

Event Narratives#

D

Patient 1

DURING A TRANSURETHRAL RESECTION OF THE PROSTATE PROCEDURE THEY EXPERIENCED ARCHING WITH THIS ELECTRODE. NO PT INJURY AND NO PARTS WERE LEFT BEHIND IN THE PT.

N

Patient 1

AT THE TIME OF THIS REPORT, MULTIPLE ATTEMPTS TO OBTAIN FURTHER INFO FROM THE HOSPITAL HAVE BEEN UNSUCCESSFUL, AND THE DEVICE HAS NOT YET BEEN RETURNED FOR EVAL. AS A RESULT, A DETERMINATION CANNOT BE MADE AT THIS TIME. IF FURTHER INFO BECOMES AVAILABLE, GYRUS AMCI WILL CONTINUE THE INVESTIGATION AND UPDATE THE AGENCY ACCORDINGLY.