inforMED
MalfunctionFHO

PNEUMO-MATIC INSUFFLATION VERESSNEEDLE

Received Mar 31, 2020 · Event occurred Mar 27, 2020

Report MW5093999 · MDR key 9910418

Device

Generic name

Pneumoperitoneum Needle

Model number

900-200

Catalog number

900-200

Lot number

277792

Product problems

  • Obstruction of Flow

Patient

52 YR

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

Narrative

Description of Event or Problem

PNEUMO-MATIC INSUFFLATION NEEDLE TIP OCCLUDED BY WHAT APPEARED TO BE EXTERNAL WHITE, THEN UNDERLYING RED PLASTIC. FDA SAFETY REPORT ID # (B)(4).