HARMONIC SCALPELS/SHEARS
Received Jul 20, 2022 · Event occurred Jun 23, 2022
Report 2134070-2022-00014 · MDR key 15070196
Device
Generic name
Electrosurg, Cut & Coag Accessories, Laparoscopic & Endoscopic, Reprocessed
Manufacturer
Sterilmed, Inc.Model number
HAR36RCatalog number
HAR36R
Product problems
- Detachment of Device or Device Component
- Detachment of Device or Device Component
Patient
Unknown
- No Clinical Signs, Symptoms or Conditions
- No Clinical Signs, Symptoms or Conditions
Narrative
Description of Event or Problem
IT WAS REPORTED THAT A PATIENT UNDERWENT A LAPAROSCOPIC GASTRIC BYPASS PROCEDURE WITH A REPROCESSED HARMONIC SCALPELS/SHEARS AND THE TIP BROKE OFF. THE TIP WAS BELIEVED TO RETRIEVED AND DISCARDED. A NEW DEVICE WAS USED TO COMPLETE THE PROCEDURE WITH NO PATIENT HARM. ATTEMPT HAS BEEN MADE TO OBTAIN CLARIFICATION TO THIS COMPLAINT. HOWEVER, NO FURTHER INFORMATION HAS BEEN MADE AVAILABLE.
Additional Manufacturer Narrative
THE DEVICE HAS NOT YET BEEN RETURNED FOR ANALYSIS. THIS REPORT IS BEING SUBMITTED PURSUANT TO THE PROVISIONS OF 21 CFR, PART 4. THIS REPORT MAY BE BASED ON INFORMATION WHICH HAS NOT BEEN INVESTIGATED OR VERIFIED PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION BY STERILMED, INC., OR ITS EMPLOYEES THAT THE REPORT CONSTITUTES AN ADMISSION THAT THE PRODUCT, STERILMED, INC., OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE POTENTIAL EVENT DESCRIBED IN THIS REPORT. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL REPORT, A FOLLOW-UP REPORT WILL BE FILED AS APPROPRIATE. MANUFACTURER'S REF. (B)(4).
Additional Manufacturer Narrative
ADDITIONAL INFORMATION WAS RECEIVED ON 21-JUL-2022. THE SURGEON STATED THAT THERE WERE NO SIGNS OF THE DEVICE HAVING DIFFICULTY BEFORE THE BLADE BROKE. THE DEVICE WAS BEING USED IN THE CASE AS IT ALWAYS IS. THE SURGEON DOES TAKE BITES OF SOFT TISSUE AFTER IT HAS BEEN STAPLED AND COULD HAVE HAD A STAPLE IN THE JAWS DURING ACTIVATION. THIS IS SOMETHING THAT HE ALWAYS DOES. THE BLADE BROKE AND IT WAS RETRIEVED WITHOUT ISSUE. THE PRODUCT WAS DISCARDED BY MISTAKE, THEREFORE IT CAN NOT BE RETURNED. SINCE THE DEVICE HAS BEEN REPORTED AS DISCARDED, NO PRODUCT INVESTIGATION CAN BE PERFORMED, AND THE CUSTOMER COMPLAINT CANNOT BE CONFIRMED. IF ADDITIONAL INFORMATION IS RECEIVED REGARDING THIS EVENT, A SUPPLEMENTAL 3500A REPORT WILL BE SUBMITTED TO THE FDA. MANUFACTURER'S REF. NO: (B)(4).