inforMED
MalfunctionFFL

NCIRCLE DELTA WIRE TIPLESS STONE EXTRACTOR

Received Jun 30, 2026 · Event occurred Jun 9, 2026

Report 1820334-2026-00688 · MDR key 25665552

Device

Generic name

Ffl, Dislodger, Stone, Basket, Ureteral, Metal

Manufacturer

Cook Inc

Model number

G19110

Catalog number

NTSED-024115-UDH

Lot number

16895235

Product problems

  • Difficult to Open or Close

Patient

NA · Unknown

  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

E1 - PHONE NUMBER: (B)(6) G4 - PMA/510(K): EXEMPT H3 - DEVICE HAS BEEN RETURNED AND PRELIMINARY EVALUATION HAS BEEN PERFORMED, HOWEVER, OUR INVESTIGATION IS ONGOING AND DEVICE EVALUATION SUMMARY WILL BE INCLUDED IN OUR FOLLOW UP REPORT ONCE OUR INVESTIGATION HAS BEEN COMPLETED. THIS REPORT INCLUDES INFORMATION KNOWN AT THIS TIME. A FOLLOW UP REPORT WILL BE SUBMITTED SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE. THIS REPORT IS REQUIRED BY THE FDA UNDER 21 CFR PART 803. THIS REPORT IS BASED ON UNCONFIRMED INFORMATION SUBMITTED BY OTHERS. NEITHER THE SUBMISSION OF THIS REPORT NOR ANY STATEMENT MADE IN IT IS INTENDED TO BE AN ADMISSION THAT ANY COOK DEVICE IS DEFECTIVE OR MALFUNCTIONED; THAT A DEATH OR SERIOUS INJURY OCCURRED; OR THAT ANY COOK DEVICE CAUSED OR CONTRIBUTED TO; OR IS LIKELY TO CAUSE OR CONTRIBUTE TO A DEATH OR SERIOUS INJURY IF A MALFUNCTION OCCURRED.

Description of Event or Problem

IT WAS REPORTED DURING A BILATERAL URETEROSCOPY LITHOTRIPSY PROCEDURE THE NCIRCLE DELTA WIRE TIPLESS STONE EXTRACTOR WAS UNABLE TO OPEN AND CLOSE. THE PROCEDURE WAS COMPLETED THROUGH OPENING ANOTHER BASKET ON THE SHELF. AS REPORTED, THE PATIENT DID NOT EXPERIENCE ANY ADVERSE EFFECTS OR REQUIRE ANY ADDITIONAL PROCEDURES DUE TO THIS OCCURRENCE.