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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: COVIDIEN MFG DC BOULDER EDGE; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES

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COVIDIEN MFG DC BOULDER EDGE; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES Back to Search Results
Model Number E2450H-GNSB
Medical Device Problem Codes Fire (1245); Peeled/Delaminated (1454); Insufficient Device Problem Information (3190)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/21/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
D10 concomitant products: e2450h-gnsb, e2450h-gnsb disp b sw pencil (edge+h) (lot#:243550006r).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.
 
Event or Problem Description
It was reported that during the abdominal repair, the first pack caught on fire upon opening the device.Then the physician and obstetric triage (obt) noticed a small red spark fire at the tip of the bovie wand while it was being used on the fascia muscle.The wand was quickly removed and replaced with a new one, and the rest of the abdominal closure went smoothly.It was noted that the used devices had black spot on the tip.There was no patient injury.
 
Event or Problem Description
It was reported that during the abdominal repair, the physician and obstetric triage (obt) noticed a small red spark fire at the tip of the bovie wand while it was being used on the fascia muscle.The wand was quickly removed and replaced with a new one, and the rest of the abdominal closure went smoothly.It was noted that the used devices had black spot on the tip.There was no patient injury.
 
Additional Manufacturer Narrative
Additional information: b5, g3, h6.Additional review of the event and/or additional information received shows that there is no information to reasonably suggest that the device in this report may have caused or contributed to a death or serious injury or that the device in this report has malfunctioned.Therefore, this event did not and does not meet the reporting requirements in 21 cfr 803.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
EDGE
Common Device Name
ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES
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 Key22282271
Report Number1717344-2025-00806
Device Sequence Number8327397
Product Code GEI
UDI-Device Identifier10884524002248
UDI-Public10884524002248
Combination Product (Y/N)N
Initial Reporter StateTN
Initial Reporter CountryUS
PMA/510(K) Number
K962044
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Distributor
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 06/24/2025
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 Model NumberE2450H-GNSB
Device Catalogue NumberE2450H-GNSB
Device Lot Number243550006R
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/26/2025
Supplement Date Received by Manufacturer06/18/2025
Initial Report FDA Received Date06/18/2025
Supplement Report FDA Received Date06/24/2025
Date Device Manufactured12/20/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
SEE H11
Patient SexUnknown
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