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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: COVIDIEN MANSFIELD TruClear; HYSTEROSCOPE (AND ACCESSORIES)

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COVIDIEN MANSFIELD TruClear; HYSTEROSCOPE (AND ACCESSORIES) Back to Search Results
Model Number 72202536
Medical Device Problem Code Detachment of Device or Device Component (2907)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/12/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during the procedure, the inner-tube of the blade was broken.The fracture occurred inside the handpiece.No device fragments detached or entered the patient's body.They completed the procedure with an alternative method.There was no patient injury.
 
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
TruClear
Common Device Name
HYSTEROSCOPE (AND ACCESSORIES)
Manufacturer (Section D)
COVIDIEN MANSFIELD
15 hampshire street
mansfield MA 02048
Manufacturer (Section G)
COVIDIEN MANSFIELD
15 hampshire street
mansfield MA 02048
Manufacturer Contact
mike bocchino
8200 coral sea st ne
mounds view, MN 55112--439
+1(800)646-4633
MDR Report Key50668659
Report Number1282497-2026-00053
Device Sequence Number9228427
Product Code HIH
UDI-Device Identifier10884521744080
UDI-Public(01)10884521744080(17)280912(10)5935322(20)02
Combination Product (Y/N)N
Initial Reporter CountryTW
PMA/510(K) Number
K132015
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative,Distributor
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 09/08/2026
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 Number72202536
Device Catalogue Number72202536
Device Lot Number5935322
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 08/12/2026
Initial Report FDA Received Date09/08/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured09/12/2025
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 SexFemale
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