MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2013-08-27 for XCEL * B15LT manufactured by Ethicon Endo-surgery, Inc..
[21965659]
During laparoscopic gastric bypass surgery, the surgeon reports two trocar ports leaking, resulting in decrease insufflation of abdomen. The 15mm bladeless ethicon trocar (ref # b15lt, lot # k4cz72) is new while 5mm bladeless ethicon trocar (lot # 2503719 ref# cb5lt) is reprocessed. Both devices continue to be used. Unable to sequester at this time.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3359415 |
| MDR Report Key | 3359415 |
| Date Received | 2013-08-27 |
| Date of Report | 2013-08-27 |
| Date of Event | 2013-08-06 |
| Report Date | 2013-08-27 |
| Date Reported to FDA | 2013-08-27 |
| Date Reported to Mfgr | 2013-09-20 |
| Date Added to Maude | 2013-09-20 |
| Event Key | 0 |
| Report Source Code | User Facility report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | XCEL |
| Generic Name | TROCAR |
| Product Code | GCJ |
| Date Received | 2013-08-27 |
| Model Number | * |
| Catalog Number | B15LT |
| Lot Number | LOT # K4CZ72 |
| ID Number | * |
| Operator | PHYSICIAN |
| Device Availability | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ETHICON ENDO-SURGERY, INC. |
| Manufacturer Address | 4545 CREEK ROAD CINCINNATI OH 45242 US 45242 |
| Brand Name | * |
| Generic Name | TROCAR |
| Product Code | NMK |
| Date Received | 2013-08-27 |
| Model Number | * |
| Catalog Number | CB5LT |
| Lot Number | 2503719 |
| ID Number | * |
| Device Availability | Y |
| Device Sequence No | 2 |
| Device Event Key | 0 |
| Manufacturer | ETHICON ENDO SURGERY, INC. |
| Manufacturer Address | 4545 CREEK ROAD CINCINNATI OH 45242 US 45242 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2013-08-27 |