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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC ADVANCED ENERGY (SALIENT) PLASMABLADE 3.0S; ELECTROSURGICAL, CUTTING & COAGULATION & ACCES

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MEDTRONIC ADVANCED ENERGY (SALIENT) PLASMABLADE 3.0S; ELECTROSURGICAL, CUTTING & COAGULATION & ACCES Back to Search Results
Model Number PS210-030S
Medical Device Problem Codes No Device Output (1435); Device Damaged Prior to Use (2284)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/27/2021
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
If information is provided in the future, a supplemental report will be issued.
 
Event or Problem Description
Information was received from a healthcare professional (hcp) via a manufacture representative (rep) regarding two handpieces.It was reported that when they we went to use a handpiece and when was taking it out of its box, they found it wasn¿t sealed so they opened a second one to also find that one was also not sealed, therefore both products were not sterile.There was no patient involved.
 
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Brand Name
PLASMABLADE 3.0S
Common Device Name
ELECTROSURGICAL, CUTTING & COAGULATION & ACCES
Manufacturer (Section D)
MEDTRONIC ADVANCED ENERGY (SALIENT)
180 international drive
portsmouth NH 03801
MDR Report Key12252583
Report Number1226420-2021-00116
Device Sequence Number3900755
Product Code GEI
UDI-Device Identifier00643169617148
UDI-Public00643169617148
Combination Product (Y/N)N
Initial Reporter CountryNZ
PMA/510(K) Number
K093695
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source company representative,foreig
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 07/30/2021
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
Operator of Device Health Professional
Device Expiration Date10/29/2022
Device Model NumberPS210-030S
Device Catalogue NumberPS210-030S
Device Lot Number0218773538
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/28/2021
Initial Report FDA Received Date07/30/2021
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
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