MAUDE MDR 8411495

MDR report key
8411495
Report number
3007699067-2019-00001
Event key
0
Event type
3
Date of event
2017-07-19
Date received
2019-03-12
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
1
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS MONIKA LEWANDOWSKA
Address
FORMERVANGEN 5 GLOSTRUP, DENMARK DA DK260 DA
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1LINA POWER MORCELLATORLINA MORCELLATORLINA MEDICAL APSHETUNKNOWNUNKNOWNUNKNOWNR N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-03-1201. O

Event Narratives#

N

Patient 1

BASED ON DESCRIPTION PLACED IN MW5083832 WE CAN CONDUCT THAT INCIDENT WASN'T CONNECTED WITH DEVICE MALFUNCTION. FURTHERMORE DEVICE INFORMATION IS NOT SUFFICIENT TO BE SURE THAT MENTIONED DEVICE WAS MANUFACTURE BY LINA MEDICAL. NO FURTHER ACTION REQUIRED.

D

Patient 1

ABOVE DESCRIPTION WAS COPIED FROM MW5083832 REPORT PROVIDED TO LINA BY (B)(6). LINA MEDICAL APS HAVEN'T BEEN AWARDED ABOUT SUCH EVENT. "THE PATIENT UNDERWENT POWER MORCELLATION USING THE VERSION OF THIS DEVICE MANUFACTURED BY LINA DURING THE COURSE OF A ROBOTIC MYOMECTOMY PROCEDURE FOR SYMPTOMATIC FIBROID DISEASE, ASSUMED TO BE BENIGN. THE PROCEDURE WAS PERFORMED AT (B)(6) HOSPITAL IN (B)(6). THE PATIENT WAS NOT INFORMED OF THE POSSIBILITY OF A UTERINE SOFT TISSUE SARCOMA MASQUERADING AS A FIBROID DISEASE - DESPITE CONCERNING FEATURES AND CLINICAL SYMPTOMS. THE PATIENT WAS NOT CONSENTED FOR THE USE OF A POWER MORCELLATOR DURING THE MYOMECTOMY OPERATION. WITHIN SEVERAL MONTHS, THE PATIENT DEVELOPED EXTENSIVE ABDOMINAL SARCOMATOSIS AND IN NOW BATTLING AN ADVANCED STAGE IATROGENIC ABDOMINAL SARCOMATOSIS." ALL INFORMATION FILL IN THE NEXT STEPS ARE ALSO COPY FROM MW5083832 REPORT. INFORMATION ARE NOT SUFFICIENT TO CONDUCT WHAT PRODUCT IT WAS EXACTLY (LACK OF REF NUMBER AND BATCH NUMBER)