SITUATE 01-0031

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,user f report with the FDA on 2020-01-30 for SITUATE 01-0031 manufactured by Mitg - Rf Surgical Systems.

Event Text Entries

[187102896] If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


[187102897] According to the reporter, during a procedure, the counts were correct; however, the patient was scanned with the body scanner and it gave a detection. Scanned with the wand but was clear. The patient was then scanned again with the body scanner and still registered a detection. Scanned with the wand again and received a clear scan. The patient was x-rayed and the results were negative. The case was extended while trying to reconcile whether or not the detection was true or false.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3005883396-2020-00006
MDR Report Key9649254
Report SourceCOMPANY REPRESENTATIVE,USER F
Date Received2020-01-30
Date of Report2020-01-30
Date of Event2020-01-14
Date Mfgr Received2020-01-15
Date Added to Maude2020-01-30
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 ContactLISA HERNANDEZ
Manufacturer Street5920 LONGBOW DRIVE
Manufacturer CityBOULDER CO 80301
Manufacturer CountryUS
Manufacturer Postal80301
Manufacturer Phone2034925563
Manufacturer G1MITG - RF SURGICAL SYSTEMS
Manufacturer Street2101 FARADAY
Manufacturer CityCARLSBAD CA 92008
Manufacturer CountryUS
Manufacturer Postal Code92008
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSITUATE
Generic NameCOUNTER, SPONGE, SURGICAL
Product CodeLWH
Date Received2020-01-30
Model Number01-0031
Catalog Number01-0031
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerMITG - RF SURGICAL SYSTEMS
Manufacturer Address2101 FARADAY CARLSBAD CA 92008 US 92008


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-01-30

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