MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a user facility report with the FDA on 2018-04-12 for AA01 HIGH TEMPERATURE FINE TIP CAUTERY manufactured by Bovie Medical Corporation.
[105369460]
Preliminary investigation confirmed that no flammable gases were in the immediate area. Reported that the tip sparked, causing a fire with the gauze. The gauze was knocked to the floor and put out.
Patient Sequence No: 1, Text Type: N, H10
[105369461]
Reported that physician was performing a punch biopsy procedure while using a bovie cautery (aa01) a gauze caught fire. The patient received a first-degree burn.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3007593903-2018-00014 |
| MDR Report Key | 7426888 |
| Report Source | USER FACILITY |
| Date Received | 2018-04-12 |
| Date of Report | 2018-04-11 |
| Date of Event | 2018-03-21 |
| Date Mfgr Received | 2018-03-21 |
| Device Manufacturer Date | 2017-06-06 |
| Date Added to Maude | 2018-04-12 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 0 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MRS DANNELLE LAO |
| Manufacturer Street | 5115 ULMERTON ROAD |
| Manufacturer City | CLEARWATER FL 337604004 |
| Manufacturer Country | US |
| Manufacturer Postal | 337604004 |
| Manufacturer Phone | 7273842323 |
| Manufacturer G1 | BOVIE MEDICAL CORPORATION |
| Manufacturer Street | 5115 ULMERTON ROAD |
| Manufacturer City | CLEARWATER FL 337604004 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 337604004 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | AA01 HIGH TEMPERATURE FINE TIP CAUTERY |
| Generic Name | AA01 |
| Product Code | GEI |
| Date Received | 2018-04-12 |
| Catalog Number | AA01 |
| Lot Number | 0617E |
| Operator | PHYSICIAN |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 0 |
| Device Event Key | 0 |
| Manufacturer | BOVIE MEDICAL CORPORATION |
| Manufacturer Address | 5115 ULMERTON ROAD CLEARWATER FL 337604004 US 337604004 |
| Brand Name | AA01 HIGH TEMPERATURE FINE TIP CAUTERY |
| Generic Name | AA01 |
| Product Code | HQP |
| Date Received | 2018-04-12 |
| Catalog Number | AA01 |
| Lot Number | 0617E |
| Operator | PHYSICIAN |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BOVIE MEDICAL CORPORATION |
| Manufacturer Address | 5115 ULMERTON ROAD CLEARWATER FL 337604004 US 337604004 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2018-04-12 |