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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: COVIDIEN MFG DC BOULDER VALLEYLAB FT10; ELECTROSURGICAL, CUTTING & COAGULATION & ACCES

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COVIDIEN MFG DC BOULDER VALLEYLAB FT10; ELECTROSURGICAL, CUTTING & COAGULATION & ACCES Back to Search Results
Model Number VLFT10GEN
Device Problems Application Program Problem: Parameter Calculation Error (1449); Device Displays Incorrect Message (2591)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Type  malfunction  
Event Description
According to the reporter, prior to use, the handpieces that were connected to the generator with software version of 4.0.4 had an error 420 code. the devices had not been reprocessed or remanufactured.There was no patient involvement.Medtronic's initial evaluation of the incident device found an ft10 generator software issue related to the customer's operating software version in which the authentication check gives an incorrect error message.
 
Manufacturer Narrative
D10: concomitant product/s: lf1937, jaw lap lf1937 ligasure maryland 37cm, (lot #32350308x) lf1937, jaw lap lf1937 ligasure maryland 37cm, (lot #33050382x) lf4418, open sealer lf4418 curved large jaw, (lot #32770254x) lf4418, open sealer lf4418 curved large jaw, (lot #32400312x).Medtronic conducted an investigation based upon all information received.The device data was available for evaluation.An evaluation was led of a vlft10gen for a non-reportable condition involving an error message with a ligasure device.During the investigation, a generator software issue was identified as being related to the reported error message in which this error message may occur when the vlft10gen generator performs an authentication check to confirm that the ligasure instrument has not been used previously.This identified software issue has a potential for patient harm.Software enhancements have been implemented to mitigate this condition.Medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
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Brand Name
VALLEYLAB FT10
Type of Device
ELECTROSURGICAL, CUTTING & COAGULATION & ACCES
Manufacturer (Section D)
COVIDIEN MFG DC BOULDER
5920 longbow dr
boulder CO 80301 3299
Manufacturer (Section G)
COVIDIEN MFG DC BOULDER
5920 longbow dr
boulder CO 80301 3299
Manufacturer Contact
justin ellis
8200 coral sea st ne
mounds view, MN 55112
7635265677
MDR Report Key19005959
MDR Text Key339237789
Report Number1717344-2024-00839
Device Sequence Number1
Product Code GEI
UDI-Device Identifier10884521548350
UDI-Public10884521548350
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K151649
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date 03/29/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received03/29/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberVLFT10GEN
Device Catalogue NumberVLFT10GEN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received03/08/2024
Was Device Evaluated by Manufacturer? Yes
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
Treatment
SEE H11
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