ENDOWRIST 470309

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-03-30 for ENDOWRIST 470309 manufactured by Intuitive Surgical, Inc..

Event Text Entries

[185503045] Broke with 3 lives left, wheel fell off back of instrument. Manufacturer response for mega suture cut needle, mega suture cut needle driver (per site reporter). Failure analysis investigations replicated/confirmed the customer reported defective i&a "wheel fell off the back of the instrument. " the instrument was found to hav an input disk broken. Input disk #7 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


MAUDE Entry Details

Report Number9897179
MDR Report Key9897179
Date Received2020-03-30
Date of Report2020-03-02
Date of Event2020-01-10
Report Date2020-03-02
Date Reported to FDA2020-03-02
Date Reported to Mfgr2020-03-30
Date Added to Maude2020-03-30
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
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
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameENDOWRIST
Generic NameSYSTEM,SURGICAL,COMPUTER CONTROLLED INSTRUMENT
Product CodeNAY
Date Received2020-03-30
Returned To Mfg2020-01-27
Model Number470309
Lot NumberN10190909(0139)
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Age1 DA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerINTUITIVE SURGICAL, INC.
Manufacturer Address1266 KIFER ROAD SUNNYVALE CA 94086 US 94086


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-30

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