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Recall Observatory FDA recall evidence

Device product

Disposable Accessory Kit, 3-Arm (Box of 5) individually sealed in poly-Tyvek pouches / Rx Sterile / to used exclusively on the Intuitive Surgical Da Vinci Si Robotic system / Distributed by Intuitive Surgical Product Usage: Microtek Medical Equipment Drapes are intended to cover/wrap various surgical and/or nonsurgical instruments/equipment [e.g. robotic arms, microscopes, tables, x ray systems, light handles, etc]. They function as a physical barrier to prevent cross contamination between the instrument / equipment and medical staff and/or to allow the instrument/equipment to enter a hygienic area [e.g. sterile surgical field] in various clinical settings. They are typically made of flexible plastic and shaped to fit the type of instrument / equipment. They are a single use device [not to be reprocessed]

Z-0233-2019

September 14, 2018

Class II

Product summary

Firm
Ecolab Inc
Event
Event 81244
Status
Terminated
Classification
Class II
Quantity
4,861 cases (24,305 eaches)
Official record key
device-enforcement:Z-0233-2019

Official wording

Reason: The pouches of certain lots of product may have wrinkles along the pouch seal that could result in a channel within the seal. Should there be a channel in the pouch seal it may result in a breach in the sterility of the product.

Code information: Item 420290-03 Lots # D173047, D173557, D173017, D180127, D172917, D180137, D172827, D172897, D180197A, D172757, D173037, D173557A, D180297, D172907, D180127A, D173207, D172847, D180397, D180037, D180287, D180267, D180197, D180277, D180417, D172787, D180047, D173057, D180407, D172797, D173567, D180477, and D180607.

Distribution pattern: Worldwide - US Nationwide Distribution in the states of AK, AL, AZ, CA, CO, CT, DC, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, WA, WI, WV, AND WY In the countries of Argentina, Australia, Austria, Belgium, Canada, Chile, China, Colombia, Czech Republic, Denmark, Finland, France, Germany, Guadeloupe, Iceland, Ireland, Italy, Martinique, Netherlands, Norway, Russian Federation, Saudi Arabia, Singapore, South Africa, Spain, Sweden, Switzerland, Taiwan, Thailand, and United Kingdom

Derived failure modes

  • Labeling or packaging

    reason.labeling_packaging · v1.0.0

    pouch seal it may result in a breach
  • Sterility assurance

    reason.sterility_assurance · v1.0.0

    seal. Should there be a channel in the pouch seal it may result in a breach in the sterility