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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: COVIDIEN EDGE; ELECTROSURGICAL, CUTTING & COAGULATION & ACCES

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COVIDIEN EDGE; ELECTROSURGICAL, CUTTING & COAGULATION & ACCES Back to Search Results
Model Number E1455NSB
Medical Device Problem Codes Peeled/Delaminated (1454); Detachment of Device or Device Component (2907)
Health Effect - Clinical Code Insufficient Information (4580)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that a device in a pack had a plastic tip came off.
 
Additional Manufacturer Narrative
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 & ACCES
Manufacturer (Section D)
COVIDIEN
boulevard insurgentes 19030
tijuana,mx
Manufacturer (Section G)
COVIDIEN
boulevard insurgentes 19030
tijuana,mx
Manufacturer Contact
mike bocchino
8200 coral sea st ne
mounds view, MN 55112-4391
8006464633
MDR Report Key23777555
Report Number9610849-2025-00108
Device Sequence Number15981931
Product Code GEI
UDI-Device Identifier10884521037137
UDI-Public(01)10884521037137(11)250730(10)252110011R(20)01
Combination Product (Y/N)N
Initial Reporter StateIL
Initial Reporter CountryUS
PMA/510(K) Number
K955836
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Distributor
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 12/11/2025
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 NumberE1455NSB
Device Catalogue NumberE1455NSB
Device Lot Number252110011R
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/14/2025
Initial Report FDA Received Date12/11/2025
Date Device Manufactured07/30/2025
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
Patient SexUnknown
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