inforMED
InjuryJOS

E-Z CLEAN ELECTRODE

Received Nov 2, 2017

Report 1721194-2017-00008 · MDR key 6996780

Device

Generic name

E-z Clean Electrode, Blade, Modified

Model number

0012M

Catalog number

0012M

Lot number

UNKNOWN

Product problems

  • Adverse Event Without Identified Device or Use Problem
  • Adverse Event Without Identified Device or Use Problem

Patient

Not reported

  • Burn(s)
  • Burn(s)

Narrative

Additional Manufacturer Narrative

ALL ATTEMPTS TO GAIN INFORMATION ABOUT THE PATIENT OR THE EVENT HAVE BEEN UNSUCCESSFUL. WITHOUT LOT NUMBER INFORMATION WE ARE UNABLE TO IDENTIFY THE MANUFACTURE DATE. A REVIEW OF PRODUCT HISTORY REVEALS THIS DEVICE TO BE A RELIABLE COMPONENT OF ELECTROSURGERY AND THERE IS NO EVIDENCE TO SUGGEST A DEVICE DEFECT OR MALFUNCTION.

Description of Event or Problem

SECONDARY BURN UTILIZING A 0012M WITH A MEDLINE PENCIL IS AN ENT PROCEDURE.