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 |