inforMED
MalfunctionJOS

REUSABLE MONOPOLAR ELECTRODE

Received Mar 16, 2018 · Event occurred Feb 21, 2018

Report 9611102-2018-00004 · MDR key 7347249

Device

Generic name

Monopolar Electrode

Model number

8416031

Catalog number

8416031

Product problems

  • Overheating of Device
  • Overheating of Device

Patient

Not reported

  • No Information
  • No Information

Narrative

Additional Manufacturer Narrative

UNABLE TO INVESTIGATION/EVALUATION DUE TO ACTUAL DEVICE NOT BEING RETURNED TO MANUFACTURER AND NO LOT NUMBER SUPPLIED BY USER FACILITY. FACILITY WAS CONTACTED IN AN EFFORT TO GATHER MISSING MEDWATCH INFORMATION, THE DEVICE IN QUESTION AND/OR PHOTOS OR VIDEOS OF THE DEVICE. NO RESPONSE AS OF YET. RICHARD WOLF (B)(4) ((B)(6)) CONSIDERS THIS MATTER CLOSED. HOWEVER, IN THE EVENT (B)(6) RECEIVES ANY ADDITIONAL INFORMATION A FOLLOW UP REPORT WILL BE SUBMITTED TO FDA. RICHARD WOLF MEDICAL INSTRUMENTS CORPORATION (RWMIC) SUBMITTING REPORT ON BEHALF OF (B)(4) REPORT ON BEHALF OF (B)(4).

Description of Event or Problem

SUSPECT DEVICE WAS USED ON A TUMOR ON A CHILDS SMALL INTESTINE. THE LOOP COMPLETELY DEGRADED AND WAS NEVER FOUND AGAIN. PROCEDURE WAS COMPLETED.