LAPAROSCOPIC EQUIPMENT ME 2093.00/5119.00 (ESU)

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1994-04-13 for LAPAROSCOPIC EQUIPMENT ME 2093.00/5119.00 (ESU) manufactured by Richard Wolf Medical Instruments Corp..

Event Text Entries

[15011192] Pt scheduled for laparoscopic cholecystectomy. Surgeon attempted laparoscopic cholecystectomy, proceeded to open cholecystectomy. Device not labeled for single use. Patient medical status prior to event: satisfactory condition. There was not multiple patient involvement. Device serviced in accordance with service schedule. Date last serviced: 01-feb-93. Service provided by: invalid data. Service records available. No imminent hazard to public health claimed. Device used as labeled/intended. Device was evaluated after the event. Method of evaluation: actual device involved in incident was evaluated, electrical tests performed. Results of evaluation: invalid data. Conclusion: user error caused event, other. Certainty of device as cause of or contributor to event: invalid data. Corrective actions: device discarded. Invalid data - on device destroyed/disposed of status.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number8042
MDR Report Key8042
Date Received1994-04-13
Date of Report1994-04-07
Report Date1994-04-07
Date Reported to FDA1994-04-07
Date Added to Maude1994-06-21
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional0
Initial Report to FDA0
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameLAPAROSCOPIC EQUIPMENT
Generic NameLAPAROSCOPIC EQUIPMENT
Product CodeKOA
Date Received1994-04-13
Model NumberME 2093.00/5119.00 (ESU)
Catalog NumberME 2093.00/5119.00 (ESU)
OperatorOTHER HEALTH CARE PROFESSIONAL
Device AvailabilityY
Device Age01-NOV-90
Implant FlagN
Device Sequence No1
Device Event Key7717
ManufacturerRICHARD WOLF MEDICAL INSTRUMENTS CORP.


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 1994-04-13

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