NOVAPASS REVERDIN SUTURE PASSER N/A C-PAS-30-11.4

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2016-09-13 for NOVAPASS REVERDIN SUTURE PASSER N/A C-PAS-30-11.4 manufactured by Cook Inc.

Event Text Entries

[54575596] Blank fields on this form indicate the information is unknown or unavailable. (b)(4). This event is currently under investigation.
Patient Sequence No: 1, Text Type: N, H10


[54575597] It was reported during a component separation and abdominal wall repair in the abdomen procedure on a male patient the surgeon punctured his skin with the device. The surgeon stated repeatedly that the device was sharp, but difficult to pass through tissue. On one occasion during this case the surgeon received a sharp injury to the finger or thumb as a result of the suture passer distal tip puncturing the skin during one of the passes through tissue. The surgeon removed the instrument from the sterile field and removed the glove. At this time betadine was poured liberally onto the affected area and then re-gloved. The procedure was continued with a new suture passer. Even with the second suture passer the surgeon commented that it was still difficult to pass through tissue and required significant force and then eventually "just gave way".
Patient Sequence No: 1, Text Type: D, B5


[62806545] (b)(4). Product has not been received and the investigation is ongoing. A follow up report will be sent upon completion of the investigation.
Patient Sequence No: 1, Text Type: N, H10


[62806546] It was reported during a component separation and abdominal wall repair in the abdomen procedure on a male patient the surgeon punctured his skin with the device. The surgeon stated repeatedly that the device was sharp, but difficult to pass through tissue. On one occasion during this case the surgeon received a sharp injury to the finger or thumb as a result of the suture passer distal tip puncturing the skin during one of the passes through tissue. The surgeon removed the instrument from the sterile field and removed the glove. At this time betadine was poured liberally onto the affected area and then re-gloved. The procedure was continued with a new suture passer. Even with the second suture passer the surgeon commented that it was still difficult to pass through tissue and required significant force and then eventually? Just gave way".
Patient Sequence No: 1, Text Type: D, B5


[78991094] Investigation - evaluation: a review of the complaint history, device history record, documentation, instructions for use (ifu), specifications and quality control was conducted during the investigation. The complaint device was not returned therefore, no physical examinations could be performed; however, a document based investigation evaluation was performed. There is no evidence to suggest the product was not made to specifications. Review of device history record shows no nonconforming events which could contribute to this failure mode. It should be noted there were no other reported complaints for this lot number. The device is shipped with an instruction for use (ifu) that describes the intended use; specific items are addressed such as: "do not use the suture passer in a procedure where the position of the needle tip cannot be clearly identified. Novapass suture passers have needle-point tips that can cause injury to internal tissue and/or any personnel who may come in contact with the device. The needle-point tip should be kept protected with the protective cap whenever the device is not in use. " based on the information provided, no product returned and the results of our investigation, a definitive root cause could not be determined. We will continue to monitor for similar complaints. Measures have been initiated to address this failure mode.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1820334-2016-00943
MDR Report Key5946403
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2016-09-13
Date of Report2017-05-30
Date of Event2016-08-17
Date Mfgr Received2017-02-23
Device Manufacturer Date2015-08-10
Date Added to Maude2016-09-13
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 ContactMRS. RITA HARDEN
Manufacturer Street750 DANIELS WAY
Manufacturer CityBLOOMINGTON IN 47404
Manufacturer CountryUS
Manufacturer Postal47404
Manufacturer Phone8123392235
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameNOVAPASS REVERDIN SUTURE PASSER
Generic NameGEJ CARRIER, LIGATURE
Product CodeGEJ
Date Received2016-09-13
Model NumberN/A
Catalog NumberC-PAS-30-11.4
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerCOOK INC
Manufacturer Address750 DANIELS WAY BLOOMINGTON IN 47404 US 47404


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2016-09-13

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