{ "meta": { "disclaimer": "Do not rely on openFDA to make decisions regarding medical care. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. We may limit or otherwise restrict your access to the API in line with our Terms of Service.", "terms": "https://open.fda.gov/terms/", "license": "https://open.fda.gov/license/", "last_updated": "2026-09-08", "results": { "skip": 0, "limit": 1, "total": 1 } }, "results": [ { "manufacturer_contact_zip_ext": "", "manufacturer_g1_address_2": "", "event_location": "HOSPITAL", "report_to_fda": "", "manufacturer_contact_t_name": "", "manufacturer_contact_state": "", "manufacturer_link_flag": "Y", "manufacturer_contact_address_2": "", "manufacturer_g1_city": "", "manufacturer_contact_address_1": "", "manufacturer_contact_pcity": "", "event_type": "Injury", "report_number": "2955842-2013-04945", "type_of_report": [ "Initial submission" ], "product_problem_flag": "N", "date_received": "20131101", "manufacturer_address_2": "", "pma_pmn_number": "K081137", "date_of_event": "20111109", "reprocessed_and_reused_flag": "N", "manufacturer_address_1": "", "exemption_number": "", "manufacturer_contact_zip_code": "", "reporter_occupation_code": "OTHER", "manufacturer_contact_plocal": "", "noe_summarized": "1", "manufacturer_contact_l_name": "", "source_type": [ "Other" ], "distributor_zip_code_ext": "", "manufacturer_g1_postal_code": "", "manufacturer_g1_state": "", "reporter_country_code": "", "manufacturer_contact_area_code": "", "date_added": "20131104", "manufacturer_contact_f_name": "", "previous_use_code": "", "device": [ { "device_event_key": "", "implant_flag": "", "date_removed_flag": "", "device_sequence_number": "562203", "implant_date_year": "", "date_removed_year": "", "serviced_by_3rd_party_flag": "", "date_received": "20131101", "brand_name": "DA VINCI SI SURGICAL SYSTEM", "generic_name": "ENDOSCOPIC INSTRUMENT CONTROL SYSTEM", "manufacturer_d_name": "INTUITIVE SURGICAL,INC.", "manufacturer_d_address_1": "", "manufacturer_d_address_2": "", "manufacturer_d_city": "SUNNYVALE", "manufacturer_d_state": "CA", "manufacturer_d_zip_code": "", "manufacturer_d_zip_code_ext": "", "manufacturer_d_country": "", "manufacturer_d_postal_code": "", "device_operator": "HEALTH PROFESSIONAL", "model_number": "IS3000 A6.0P8", "catalog_number": "", "lot_number": "", "other_id_number": "", "device_availability": "No", "device_report_product_code": "NAY", "device_age_text": "", "device_evaluated_by_manufacturer": "", "combination_product_flag": "N", "udi_di": "", "udi_public": "", "openfda": { "device_name": "System, Surgical, Computer Controlled Instrument", "medical_specialty_description": "Gastroenterology, Urology", "regulation_number": "876.1500", "device_class": "2" } } ], "product_problems": [ "Insufficient Device Problem Information" ], "reporter_state_code": "IL", "manufacturer_zip_code": "", "suppl_dates_mfr_received": "", "mfr_report_type": "Thirty-Day", "manufacturer_contact_country": "", "date_changed": "20250818", "health_professional": "", "summary_report_flag": "N", "manufacturer_g1_zip_code_ext": "", "manufacturer_contact_extension": "", "manufacturer_city": "", "manufacturer_contact_phone_number": "", "patient": [ { "patient_sequence_number": "1", "date_received": "20131101", "sequence_number_treatment": [ "DA VINCI SI SYSTEM INSTRUMENTS AND ACCESSORIES" ], "sequence_number_outcome": [ "Hospitalization", " R" ], "patient_age": "47 YR", "patient_sex": "", "patient_weight": "96", "patient_ethnicity": "", "patient_race": "", "patient_problems": [ "Pulmonary Embolism", "Fistula" ] } ], "distributor_city": "", "date_report": "20131004", "initial_report_to_fda": "", "distributor_state": "", "event_key": "", "manufacturer_g1_country": "", "manufacturer_contact_city": "", "mdr_report_key": "3444229", "removal_correction_number": "", "number_devices_in_event": "", "date_manufacturer_received": "20131004", "manufacturer_name": "", "report_source_code": "Manufacturer report", "remedial_action": [ "" ], "manufacturer_g1_zip_code": "", "report_to_manufacturer": "", "manufacturer_zip_code_ext": "", "manufacturer_g1_name": "", "adverse_event_flag": "Y", "distributor_address_1": "", "manufacturer_state": "", "distributor_address_2": "", "manufacturer_postal_code": "", "single_use_flag": "", "manufacturer_country": "", "mdr_text": [ { "mdr_text_key": "3783390", "text_type_code": "Description of Event or Problem", "patient_sequence_number": "1", "text": "AS PART OF A LEGAL DISPUTE, INTUITIVE SURGICAL RECEIVED INFORMATION REGARDING A PATIENT WHO UNDERWENT A DA VINCI SI DIAGNOSTIC LAPAROSCOPY, EXTENSIVE PELVIC ADHESIOLYSIS, BILATERAL URETEROLYSIS, STRIPPING OF THE PELVIC SIDEWALL PERITONEUM, RESECTION OF A RIGHT OVARIAN REMNANT, AND PARTIAL UPPER VAGINECTOMY ON (B)(6) 2011. INTUITIVE SURGICAL WAS PROVIDED WITH THE OPERATIVE REPORT. ADDITIONAL INFORMATION PROVIDED INCLUDES, HISTORY AND PHYSICAL EXAM, THERE WAS NO INDICATION OF A MALFUNCTION OF THE DA VINCI SURGICAL SYSTEM, INSTRUMENT OR ACCESSORY DURING SURGERY. THERE WAS NO REPORT OF AN INTRAOPERATIVE COMPLICATION. THE PATIENT DEVELOPED A PULMONARY EMBOLISM FOLLOWING SURGERY AND REQUIRED ANTICOAGULATION WITH COUMADIN. ON (B)(6) 2011 THE PATIENT HAD A CONSULTATION WITH A UROLOGIST FOR AN APPARENT URETEROVAGINAL FISTULA WITH DISTAL RIGHT URETER INJURY. A CT UROGRAM WAS PERFORMED AT HER HOME AFTER SHE BEGAN HAVING LEAKING FLUID PER VAGINA. ON (B)(6) 2011 THE PATIENT WAS ADMITTED TO A MEDICAL CENTER AND DIAGNOSED WITH A URETEROVAGINAL AND URETEROENTERIC FISTULA. SHE UNDERWENT A CYSTOSCOPY WITH ATTEMPTED URETERAL STENT BUT INSTEAD REQUIRED A PERCUTANEOUS NEPHROSTOMY. ON (B)(6) 2012 THE PATIENT HAD A SUBSEQUENT VISIT WITH UROLOGY FOR EXCHANGE OF NEPHROSTOMY TUBE. ON (B)(6) 2012 THE PATIENT RETURNED TO A MEDICAL CENTER FOR EXPLORATORY LAPAROTOMY, LYSIS OF ADHESIONS, RIGHT URETERAL REIMPLANTATION, AND LEFT URETERAL CATHETER PLACEMENT. THE FISTULAS HAD HEALED SPONTANEOUSLY WITH NEPHROSTOMY DRAINAGE. SHE WAS DISCHARGED ON (B)(6) 2012." }, { "mdr_text_key": "11372567", "text_type_code": "Additional Manufacturer Narrative", "patient_sequence_number": "1", "text": "BASED ON THE INFORMATION PROVIDED, INTUITIVE SURGICAL INC. (ISI) HAS NOT DETERMINED THE ROOT CAUSE FOR THE POST-OPERATIVE COMPLICATIONS EXPERIENCED BY THE PATIENT. THE OPERATIVE REPORT DOES NOT CONTAIN ANY ALLEGATION THAT A MALFUNCTION OF A DA VINCI SYSTEM, INSTRUMENT, OR ACCESSORY OCCURRED. NO PREVIOUS COMPLAINT WAS REPORTED RELATING TO THIS EVENT. THIS COMPLAINT IS BEING REPORTED DUE TO THE FOLLOWING CONCLUSION: THE PATIENT'S MEDICAL RECORDS INDICATE THAT THE PATIENT SUSTAINED A URETERAL INJURY AFTER UNDERGOING A DA VINCI SI DIAGNOSTIC LAPAROSCOPY, EXTENSIVE PELVIC ADHESIOLYSIS, BILATERAL URETEROLYSIS, STRIPPING OF THE PELVIC SIDEWALL PERITONEUM, RESECTION OF A RIGHT OVARIAN REMNANT, AND PARTIAL UPPER VAGINECTOMY. THE PATIENT HAD AN USUALLY COMPLEX MEDICAL /SURGICAL CONDITION THAT REQUIRED CAREFUL PELVIC ROBOTIC SURGERY. THE PATIENT'S EXTENSIVE UNDERLYING PELVIC FIBROSIS AND SCAR TISSUE AROUND THE URETER WERE MOST LIKELY CONTRIBUTING FACTORS FOR THE CAUSE OF THE URETERAL INJURY THAT OCCURRED. OPERATIVE REPORTS DETAIL EXTENSIVE COAPTATION OF ALL PELVIC STRUCTURES. ULTIMATELY THE CONDITION WAS CORRECTED WITH SUBSEQUENT OPERATIVE AND NON-OPERATIVE TREATMENT." } ], "number_patients_in_event": "", "distributor_name": "", "manufacturer_g1_address_1": "", "distributor_zip_code": "", "manufacturer_contact_postal_code": "", "manufacturer_contact_exchange": "", "manufacturer_contact_pcountry": "", "suppl_dates_fda_received": "" } ] }