MalfunctionJOS
ELECTRODE EXTENSION - 11"
Received May 11, 2009 · Event occurred Apr 14, 2009
Report 1717344-2009-00199 · MDR key 1465551
Device
Generic name
Electrosurgical Accessory
Manufacturer
Covidien Lp (valleylab)Catalog number
E1504
Lot number
UNK
Product problems
- Detachment Of Device Component
- Component Falling
Patient
UNK
- No Consequences Or Impact To Patient
Narrative
Additional Manufacturer Narrative
(B)(4). THE SAMPLE HAS BEEN REQUESTED BUT TO DATE THE INCIDENT SAMPLE HAS NOT BEEN RECEIVED FOR EVALUATION. IF THE SAMPLE IS RECEIVED OR IF ADDITIONAL INFO PERTINENT TO THE INCIDENT IS OBTAINED, A FOLLOW-UP REPORT WILL BE SUBMITTED.
Description of Event or Problem
THE CUSTOMER REPORTED THAT THE ELECTRODE FELL OUT OF THE EXTENDER AS IT WAS BEING REMOVED FROM THE TROCAR AND FELL INTO THE PT CAVITY. THE ELECTRODE WAS RETRIEVED. THERE WAS NO PT INJURY.