inforMED
MalfunctionNAY

DA VINCI XI SYSTEM FENESTRATED BIPOLAR FORCEPS

Received Feb 19, 2016 · Event occurred Oct 6, 2015

Report 5446453 · MDR key 5446453

Device

Generic name

System,surgical,computer Controlled Instrument

Model number

XI

Catalog number

470205

Lot number

S10150313 0057

Product problems

  • Device Or Device Fragments Location Unknown

Patient

66 YR

  • No Information
  • No Information

Narrative

Description of Event or Problem

XI DAVINCI FENESTRATED BIPOLAR MISSING 1MMX1MMX3MM PLASTIC PIECE OF INSULATION ON TIP OF INSTRUMENT - UNKNOWN IF LOST IN PT OR BEFORE INSERTED IN PT. IN THIS CASE, THERE WERE NO VISIBLE PIECES OF THE PLASTIC COVERING SEEN IN PATIENT. THE MISSING PORTION WAS NOTED AFTER IT WAS REMOVED SINCE THE JAWS OF THE INSTRUMENT WOULD NOT OPERATE PROPERLY. DUE TO THE SMALL SIZE; HOWEVER, IT COULD NOT BE DETERMINED IF IT WAS REMOVED THROUGHOUT THE COURSE OF NORMAL IRRIGATION AND SUCTIONING DURING THE SURGERY.