MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-03-30 for ENDOWRIST 470230 manufactured by Intuitive Surgical, Inc..
[185502496]
Found in sterile package with the wheel off. Manufacturer response for large hem-o-lok clip applier, large hem-o-lok clip applier (per site reporter). Failure analysis investigations replicated/ confirmed the customer reported complaint: ''wheel broken off. " the instrument was found to have an input disk 5 was found completely detached from the base of the housing. Improper cleaning during reprocessing most commonly causes this failure.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9897083 |
| MDR Report Key | 9897083 |
| Date Received | 2020-03-30 |
| Date of Report | 2020-03-02 |
| Date of Event | 2020-02-03 |
| Report Date | 2020-03-02 |
| Date Reported to FDA | 2020-03-02 |
| Date Reported to Mfgr | 2020-03-30 |
| Date Added to Maude | 2020-03-30 |
| Event Key | 0 |
| Report Source Code | User Facility report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ENDOWRIST |
| Generic Name | SYSTEM,SURGICAL,COMPUTER CONTROLLED INSTRUMENT |
| Product Code | NAY |
| Date Received | 2020-03-30 |
| Returned To Mfg | 2020-02-03 |
| Model Number | 470230 |
| Lot Number | N10180417 |
| Device Availability | R |
| Device Age | 1 DA |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | INTUITIVE SURGICAL, INC. |
| Manufacturer Address | 1266 KIFER ROAD SUNNYVALE CA 94086 US 94086 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-03-30 |