MAUDE MDR 5246115

MDR report key
5246115
Report number
1717344-2015-00842
Event key
0
Event type
3
Date of event
2015-11-12
Date received
2015-11-24
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS. SHARON MURPHY
Address
5920 LONGBOW DRIVE BOULDER CO 80301 US
Phone
203-203-2034
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1LIGASURE ADVANCE PISTOL GRIPLIGASURE VESSEL SEALING SYSTEMCOVIDIEN LPBWALF5544LF554451490024XY R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12015-11-240

Event Narratives#

N

Patient 1

(B)(4). DATE OF INITIAL REPORT : (B)(6) 2015. TO DATE THE INCIDENT SAMPLE HAS NOT BEEN RECEIVED FOR EVALUATION. IF THE SAMPLE IS RECEIVED OR IF ADDITIONAL INFORMATION PERTINENT TO THE INCIDENT IS OBTAINED A FOLLOW-UP REPORT WILL BE SUBMITTED.

D

Patient 1

THE CUSTOMER REPORTED THAT DURING A TOTAL LAPAROSCOPIC HYSTERECTOMY BLEEDING WAS OBSERVED AT THE BROAD, UTERINE AND OVARIAN LIGAMENTS WHERE THE DEVICE HAD BEEN USED. END TONES, INDICATING A COMPLETE SEAL CYCLE, WERE PROVIDED BY THE GENERATOR IN USE. A NEW DEVICE OF THE SAME TYPE WAS OPENED AND USED TO SUCCESSFULLY COMPLETE THE CASE. THERE WAS NO PATIENT INJURY.

N

Patient 1

(B)(4). ONE USED LF5544 WAS RECEIVED FOR EVALUATION. EXAMINATION OF THE RETURNED SAMPLE COULD NOT CONFIRM THE REPORTED ISSUE. THE DEVICE WAS TESTED AND MULTIPLE SEALS WERE MADE ON PORCINE TISSUE OF VARIOUS SIZES. ALL SEAL CYCLES WERE COMPLETED SATISFACTORILY AND END TONES HEARD INDICATING COMPLETED ACTIVATION CYCLES. THE INVESTIGATION FOUND THE DEVICE TO FUNCTION NORMALLY AND WITHIN SPECIFICATIONS. REVIEW OF THE DEVICE HISTORY RECORDS FOR THIS PRODUCT FOUND NO POTENTIALLY CONTRIBUTING ENTRIES. THERE ARE ENVIRONMENTAL FACTORS DURING USE THAT CAN AFFECT SEAL QUALITY, AND THE INSTRUCTIONS-FOR-USE INCLUDED WITH THIS PRODUCT LISTS TISSUE SEALING RECOMMENDATIONS AND CAUTIONS.