inforMED
MalfunctionFHO

PNEUMO-MATIC INSUFFLATION NEEDLE

Received Dec 18, 2019 · Event occurred Dec 5, 2019

Report MW5091759 · MDR key 9495952

Device

Generic name

Pneumoperitoneum Needle

Model number

900-200

Catalog number

900-200

Lot number

265897

Product problems

  • Difficult to Remove

Patient

72 YR

  • No Known Impact Or Consequence To Patient
  • No Known Impact Or Consequence To Patient

Narrative

Description of Event or Problem

PORTION OF RED PLASTIC TIP PROTECTOR ON THE PNEUMO-MATIC INSUFFLATION, NEEDLE REMAINED IN THE INSUFFLATION TIP UPON REMOVAL OF THE TIP PROTECTOR. FDA SAFETY REPORT ID # (B)(4).