120MM INSUFF NEEDLE 900-200

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-04-25 for 120MM INSUFF NEEDLE 900-200 manufactured by Coopersurgical, Inc..

Event Text Entries

[73794325] Coopersurgical, inc. Is currently investigating the reported complaint condition. It is anticipated that the device involved in the complaint shall be returned by the customer under (b)(4). Once the investigation is complete, a follow up report will be filed. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[73794326] (b)(4). "increasing problem, used to be two or three bad one's per year,then had several in past two months, now three in one case. Some of our surgeons perform an occlusion test on the field prior to utilizing the veress needle. The goal of the occlusion test is to ensure that a high pressure alarm is triggered on the insufflator prior to using the needle. In each case, sometimes following the use of several needles, they were able to trigger the high pressure alarm ruling out an issue with the insufflator. "
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1216677-2017-00025
MDR Report Key6518092
Date Received2017-04-25
Date of Report2017-07-31
Date of Event2017-03-29
Date Mfgr Received2017-03-29
Device Manufacturer Date2016-10-16
Date Added to Maude2017-04-25
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 ContactMR. NANA BANAFO
Manufacturer Street75 CORPORATE DRIVE
Manufacturer CityTRUMBULL CT 06611
Manufacturer CountryUS
Manufacturer Postal06611
Manufacturer Phone2036015200
Manufacturer G1COOPERSURGICAL, INC.
Manufacturer Street75 CORPORATE DRIVE
Manufacturer CityTRUMBULL CT 06611
Manufacturer CountryUS
Manufacturer Postal Code06611
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand Name120MM INSUFF NEEDLE
Generic Name120MM INSUFF NEEDLE
Product CodeFHO
Date Received2017-04-25
Model Number900-200
Catalog Number900-200
Lot Number213729
Device Expiration Date2020-01-03
OperatorPHYSICIAN
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerCOOPERSURGICAL, INC.
Manufacturer Address75 CORPORATE DRIVE TRUMBULL CT 06611 US 06611


Patients

Patient NumberTreatmentOutcomeDate
10 2017-04-25

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