SITUATE
Received Jan 13, 2025
Report 1717344-2025-00092 · MDR key 21142968
Device
Generic name
Counter, Sponge, Surgical
Manufacturer
Covidien Mfg Dc BoulderModel number
01-0031Catalog number
01-0031
Product problems
- False Negative Result
- Device Displays Incorrect Message
- False Negative Result
- Device Displays Incorrect Message
Patient
NA · Unknown
- No Clinical Signs, Symptoms or Conditions
- No Clinical Signs, Symptoms or Conditions
Narrative
Additional Manufacturer Narrative
MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.
Description of Event or Problem
ACCORDING TO THE REPORTER, POST OPERATIVELY, THE BODY SCANNER HAD FALSE SCAN SIGN WHEN CONNECTED AT TESTED TO SCAN. THE ERROR MESSAGE WAS ACTUALLY ELECTRICAL FAULT ERROR, BIOMED TESTED MAT WITH A NEW CONSOLE AND SAME FALSE SCAN OCCURRED. THERE WAS NO PATIENT INVOLVEMENT.
Description of Event or Problem
ACCORDING TO THE REPORTER, POST OPERATIVELY, FAULT- REPLACE ACCESSORY ERROR HAPPENED AS SOON AS THE MAT WAS PLUGGED INTO THE CONSOLE. BIOMED TESTED MAT WITH A NEW CONSOLE AND SAME ERROR OCCURRED. THERE WAS NO PATIENT INVOLVEMENT.
Additional Manufacturer Narrative
ADDITIONAL INFORMATION: B5, G3 ADDITIONAL INFORMATION RECEIVED SHOWS THAT THERE IS NO INFORMATION TO REASONABLY SUGGEST THAT THE DEVICE IN THIS REPORT MAY HAVE CAUSED OR CONTRIBUTED TO A DEATH OR SERIOUS INJURY OR THAT THE DEVICE IN THIS REPORT HAS MALFUNCTIONED. THEREFORE, THIS EVENT DOES NOT MEET THE REPORTING REQUIREMENTS IN 21 CFR 803. MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.