inforMED
MalfunctionJOS

CUTTING ELECTRODE BIPOLAR 24-26 FR 12/30 DEGREE

Received Mar 2, 2018 · Event occurred Feb 17, 2018

Report 9611102-2018-00002 · MDR key 7311124

Device

Generic name

Electrode

Manufacturer

Richard Wolf Gmbh

Model number

46222513

Catalog number

46222513

Lot number

4500224068

Product problems

  • Material Fragmentation
  • Material Fragmentation

Patient

45 YR

  • Foreign Body In Patient
  • Device Embedded In Tissue or Plaque
  • Foreign Body In Patient
  • Device Embedded In Tissue or Plaque

Narrative

Additional Manufacturer Narrative

ACTUAL DEVICE IS NOT RETURNED YET. INVESTIGATION IS CURRENTLY IN PROCESS. (B)(4) CONSIDERS THIS REPORT OPEN, FOLLOW-UP REPORT TO BE SUBMITTED ONCE INVESTIGATION IS COMPLETE. (B)(4).

Description of Event or Problem

DURING THE USE, THE WIRE LOOP ELECTRODE DETACHED AND REMAINED IN THE UTERUS OF THE PATIENT. SECOND ELECTRODE WAS USED AND DETACHED AND REMAINED IN UTERUS. TWO MDRS TO BE SUBMITTED: 9611102-2018-00002, 9611102-2018-00003.

Additional Manufacturer Narrative

(B)(4). AN INVESTIGATION WAS UNABLE TO BE PERFORMED AS THE DEVICE WAS NOT RETURNED TO THE MANUFACTURER. MULTIPLE ATTEMPTS WERE MADE TO CONTACT THE USER FACILITY, BUT NO RESPONSE WAS PROVIDED. RICHARD WOLF GMBH (RWGMBH) CONSIDERS THIS MATTER CLOSED. IN THE EVENT RWGMBH RECEIVES ADDITIONAL INFORMATION A FOLLOW UP REPORT WILL BE SUBMITTED TO FDA.

Description of Event or Problem

FOLLOW UP REPORT TO PROVIDE ADDITIONAL INFORMATION TO FDA.