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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: INTUITIVE SURGICAL, INC ENDOWRIST; CURVED-TIP STAPLER 30

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INTUITIVE SURGICAL, INC ENDOWRIST; CURVED-TIP STAPLER 30 Back to Search Results
Model Number 470530-08
Device Problems Difficult to Open or Close (2921); Mechanical Jam (2983)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 11/20/2020
Event Type  malfunction  
Manufacturer Narrative
Intuitive surgical, inc.(isi) received the curved-tip stapler 30 instrument involved with this complaint and completed the device evaluation.The customer reported complaint was confirmed but not replicated.Failure analysis found the primary failure of shifting failure to be related to the customer reported complaint.Based on the log review, the curved-tip stapler 30 instrument was found to have a shifting failure, which indicated that the shifting failure happened after initialization and occurred when the instrument was shifting to clamp from roll.The shifting failure was triggered as the instrument initiated the clamp, so tissue likely would have been between the jaws, but the instrument was not yet clamped, replicating the customer reported message.However, the shifting failure was not replicated during in-house testing.The instrument was placed and driven on an in-house system.The instrument passed the recognition and engagement tests.The instrument moved intuitively with full range of motion in all directions.The jaws opened and closed properly.The instrument clamped, fired, and unclamped successfully.The instrument was fired with a white 30 reload and no malformed staples were observed.The visual inspection was performed and no damage was observed.The root cause of this failure is not determinable.Additional finding not reported by site: the instrument was found to have a reload recognition failure based on log review.A review of the site's complaint history does not show any additional complaints related to this product and/or this event.System logs showed that the instrument was last used on system number (b)(4) on (b)(6) 2020 and it had 15 lives remaining.A review of the stapler log was conducted by an isi failure analysis engineer (fae).The following additional information was provided: logs showed that there was a shifting failure related with this curved-tip stapler 30 instrument.The shifting failure would prompt a message to the user indicating the irk may be needed.In this case the shifting failure occurred as the instrument was shifting to initiate the clamp sequence, so the instrument was not yet clamped.Based on the information provided at this time, this complaint is being reported because curved-tip stapler 30 instrument had clamping issues.Failure analysis confirmed that a shifting failure mode happened after initialization which could prevent unclamping of the instrument jaws.While there was no harm or injury to the patient and the procedure was completed with no further reported issues, the reported failure mode could likely cause or contribute to an adverse event if it were to recur.
 
Event Description
It was reported that during a da vinci-assisted pulmonary lobectomy surgical procedure, the curved-tip stapler 30 had clamping issue.The instrument release kit (irk) was used.The procedure was completed with no reported injury.Intuitive surgical inc, (isi) made multiple follow-up attempts to obtain additional information.However, no further details have been received as of the date of this report.
 
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Brand Name
ENDOWRIST
Type of Device
CURVED-TIP STAPLER 30
Manufacturer (Section D)
INTUITIVE SURGICAL, INC
3410 central expressway
santa clara CA 95051
Manufacturer (Section G)
INTUITIVE SURGICAL, INC
3410 central expressway
santa clara CA 95051
Manufacturer Contact
david wang
3410 central expressway
santa clara, CA 95051
4085232100
MDR Report Key11089130
MDR Text Key240032163
Report Number2955842-2020-11413
Device Sequence Number1
Product Code NAY
UDI-Device Identifier00886874112717
UDI-Public(01)00886874112717(10)T10190314
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K152421
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type health professional,other
Reporter Occupation Other Health Care Professional
Remedial Action Other
Type of Report Initial
Report Date 12/04/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number470530-08
Device Catalogue Number470530
Device Lot NumberT10190314
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer12/14/2020
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 12/04/2020
Initial Date FDA Received12/29/2020
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured03/14/2019
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Removal/Correction NumberN/A
Patient Sequence Number1
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