PLASMABLADE TNA PS300-002

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06,07,company representative, report with the FDA on 2014-12-22 for PLASMABLADE TNA PS300-002 manufactured by Medtronic Advanced Energy, Llc.

Event Text Entries

[5198679] During the adenoid portion of a tonsil and adenoidectomy case, the adenoid electrode wire broke. Upon inspection of the device after breakage, it was noted that the plastic housing of the adenoid tip was melted. No patient impact or injury.
Patient Sequence No: 1, Text Type: D, B5


[12674762] (b)(4). Eval, method, results: facility disposed of device. Device is not available for return and inspection. Product event: (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[103815162] If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1226420-2014-00127
MDR Report Key4349689
Report Source06,07,COMPANY REPRESENTATIVE,
Date Received2014-12-22
Date of Report2014-11-23
Date of Event2014-11-23
Date Mfgr Received2014-11-23
Date Added to Maude2015-01-07
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 FDA3
Event Location3
Manufacturer ContactKAYLEE BOISVERT
Manufacturer Street180 INTERNATIONAL DRIVE
Manufacturer CityPORTSMOUTH NH 03801
Manufacturer CountryUS
Manufacturer Postal03801
Manufacturer Phone6038426234
Manufacturer G1MEDTRONIC ADVANCED ENERGY, LLC
Manufacturer Street180 INTERNATIONAL DRIVE
Manufacturer CityPORTSMOUTH NH 03801
Manufacturer CountryUS
Manufacturer Postal Code03801
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePLASMABLADE TNA
Generic NameELECTROSURGICAL DEVICE
Product CodeDWG
Date Received2014-12-22
Model NumberPS300-002
Catalog NumberPS300-002
Lot NumberUNKNOWN
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerMEDTRONIC ADVANCED ENERGY, LLC
Manufacturer Address180 INTERNATIONAL DRIVE PORTSMOUTH NH 03801 US 03801


Patients

Patient NumberTreatmentOutcomeDate
10 2014-12-22

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