CLASSIC BIPOLAR TUBAL FCPSSCIS5MM45CM MF985

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2019-05-09 for CLASSIC BIPOLAR TUBAL FCPSSCIS5MM45CM MF985 manufactured by Aesculap Inc.

Event Text Entries

[144966266] Manufacturing site evaluation: investigation on-going. Additional information / investigation results will be provided in a supplemental report. Investigation on-going.
Patient Sequence No: 1, Text Type: N, H10


[144966267] It was reported that there was an issue with the bipolar cord and kleppinger. During a laparoscopic tubal ligation, the bipolar forceps was noted to not be working "at all". Another forceps was also attempted to be used, but it only worked intermittently. The surgeon then switched to suture ligatures instead to complete the procedure. The electric generator and pedal were working; it was unknown if the cord or the instrument malfunctioned. There was no patient harm; however, a 15-minute surgical delay occurred. Associated medwatches: 2916714-2019-00007 (this report) - not working, 2916714-2019-00009.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2916714-2019-00007
MDR Report Key8597258
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2019-05-09
Date of Report2019-05-09
Date of Event2019-03-11
Date Facility Aware2019-03-11
Date Mfgr Received2019-03-11
Date Added to Maude2019-05-09
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. LINDSAY CHROMIAK
Manufacturer Street3773 CORPORATE PARKWAY
Manufacturer CityCENTER VALLEY PA 18034
Manufacturer CountryUS
Manufacturer Postal18034
Manufacturer G1AESCULAP INC
Manufacturer Street3773 CORPORATE PARKWAY
Manufacturer CityCENTER VALLEY PA 18034
Manufacturer CountryUS
Manufacturer Postal Code18034
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameCLASSIC BIPOLAR TUBAL FCPSSCIS5MM45CM
Generic NameREUSABLE INSTRUMENTS
Product CodeHET
Date Received2019-05-09
Model NumberMF985
Catalog NumberMF985
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerAESCULAP INC
Manufacturer Address3773 CORPORATE PARKWAY CENTER VALLEY PA 18034 US 18034


Patients

Patient NumberTreatmentOutcomeDate
10 2019-05-09

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