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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC ADVANCED ENERGY (SALIENT) AEX GENERATOR; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES

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MEDTRONIC ADVANCED ENERGY (SALIENT) AEX GENERATOR; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES Back to Search Results
Model Number 40-405-1
Device Problems Fire (1245); Melted (1385)
Patient Problems Burn(s) (1757); Electric Shock (2554)
Event Date 07/23/2020
Event Type  Injury  
Manufacturer Narrative
If information is provided in the future, a supplemental report will be issued.
 
Event Description
Information was received from a healthcare professional (hcp) via a manufacture representative (rep) regarding a generator and a handpiece.It was reported that during a case, the surgeon stated he felt an electrical pulse sting when he was pressing the coagulation button.Later on, in the case, he was pressing coagulation button again and felt the electric pulse again, on his long finger.Handpiece burned his finger.There was no permanent impairment to the doctor and intervention was not necessary.The handpiece was flipped over and a burn mark was discovered on the green portion of the handpiece.Additionally, it was stated that the rep noticed that the hose was not connected to the device, appeared to have been pulled out of the handpiece.There was a reported delay of less than one hour and no impact to patient outcome.
 
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Brand Name
AEX GENERATOR
Type of Device
ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES
Manufacturer (Section D)
MEDTRONIC ADVANCED ENERGY (SALIENT)
180 international drive
portsmouth NH 03801
Manufacturer (Section G)
MEDTRONIC ADVANCED ENERGY (SALIENT)
180 international drive
portsmouth NH 03801
Manufacturer Contact
tricha miles
7000 central avenue ne rcw215
minneapolis, MN 55432
7635140379
MDR Report Key10377582
MDR Text Key201988252
Report Number1226420-2020-00083
Device Sequence Number1
Product Code GEI
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K143175
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Reporter Occupation Physician
Type of Report Initial
Report Date 08/07/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number40-405-1
Device Catalogue Number40-405-1
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 07/23/2020
Initial Date FDA Received08/07/2020
Was Device Evaluated by Manufacturer? No
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
Patient Outcome(s) Other;
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