da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED THYROIDECTOMY SURGICAL PROCEDURE, THE HARMONIC ACE INSTRUMENT SUDDENLY HAD WHITE FRAGMENTS SPATTERED AND SMOKE APPEARED WHILE USING THE ENERGY. THE FRAGMENTS WERE RETRIEVED DURING THE SAME PROCEDURE. A BACKUP INSTRUMENT OF THE SAME KIND WAS USED TO CONTINUE THE PROCEDURE. THE PROCEDURE WAS COMPLETED. INTUITIVE SURGICAL, INC. (ISI) FOLLOWED UP WITH THE INITIAL REPORTER AND OBTAINED THE FOLLOWING ADDITIONAL INFORMATION: THE INSTRUMENT WAS INSPECTED PRIOR TO USE WITH NO DAMAGE OBSERVED. WHEN THE CUSTOMER STARTED TO USE THE INSTRUMENT, IT BROKE, AND SMOKE APPEARED AT THE INSTRUMENT TIP. ALL THE FRAGMENTS WERE RETRIEVED DURING SAME PROCEDURE BY SUCTION AND CONFIRMED WITH VISUAL INSPECTION. NO ADDITIONAL SURGICAL PROCEDURE WAS REQUIRED. IT WAS UNKNOWN WHAT CAUSED THE SMOKING EVENT AND THE BREAKAGE TO OCCUR AS THE INSTRUMENT DID NOT COLLIDE WITH ANY HARD MATERIALS OR OTHER INSTRUMENTS. THE SURGEON DID NOT NOTICE ANY ISSUES WITH THE FUNCTIONALITY OF THE INSTRUMENT. THE FRAGMENT(S) DID NOT FALL INSIDE THE PATIENT DURING AN INSTRUMENT TIP OR ACCESSORY COLLISION. THE INSTRUMENT WAS NOT REMOVED DURING THE PROCEDURE (PRIOR TO THE BREAKAGE). UPON F

da Vinci Surgical System — Death report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED PARTIAL NEPHRECTOMY PROCEDURE, A THIRD PARTY STAPLER INSTRUMENT WAS USED ON UNSPECIFIED TISSUE. THE STAPLE LINE REPORTEDLY DID NOT HOLD AND CAUSED THE PATIENT TO BLEED TO DEATH. AT THIS TIME, THERE ARE NO KNOWN ALLEGATIONS AGAINST A DA VINCI PRODUCT. ON 28-JAN-2022, AN INTUITIVE SURGICAL INC. (ISI) ENTERPRISE SOLUTION MANAGER (ESM) WAS CONTACTED AND ADDITIONAL INFORMATION WAS OBTAINED ABOUT THE COMPLAINT: THE ESM WAS MADE AWARE OF THIS EVENT FROM THE SITE ROBOTICS COORDINATOR. THE CUSTOMER SITE HAS NOT PROVIDED ANY ADDITIONAL INFORMATION AT THIS TIME AS THE EVENT IS BEING REVIEWED BY THEIR RISK MANAGEMENT DEPARTMENT. IT IS UNKNOWN WHAT BRAND THIRD PARTY STAPLER WAS USED AND ON WHAT BLOOD VESSEL. THE THIRD PARTY STAPLE LINE REPORTEDLY BLED DURING THE PROCEDURE. THE SURGEON ATTEMPTED TO CONTROL THE BLEEDING AND THEN TO RESUSCITATE THE PATIENT; BUT THE PATIENT EXPIRED. IT WAS REPORTED THAT THE VESSEL THAT WAS STAPLED AND BLED WAS VERY CALCIFIED. THE SURGEON REPORTEDLY CUT MULTIPLE CABLES AT THE PATIENT BEDSIDE TO REMOVE THEM FROM THE FIELD. IT WAS REPORTED THAT THE DA VINCI SP CAMERA CABLE WAS CUT DURING THIS EVENT. ON 15-FEB-2022, ISI C

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED OVARIAN CYSTECTOMY SURGICAL PROCEDURE, THE TIP OF THE HARMONIC ACE INSTRUMENT BROKE AFTER A ¿BLADE PRESSURE¿ MESSAGE APPEARED. THE FRAGMENT THAT FELL INSIDE THE PATIENT WAS RETRIEVED DURING THE SAME PROCEDURE. A BACKUP INSTRUMENT OF SAME KIND WAS USED TO CONTINUE THE PROCEDURE. THE PROCEDURE WAS COMPLETED WITH NO REPORT OF PATIENT INJURY. INTUITIVE SURGICAL, INC. (ISI) FOLLOWED UP WITH THE INITIAL REPORTER AND OBTAINED THE FOLLOWING ADDITIONAL INFORMATION: THE INSTRUMENT WAS INSPECTED PRIOR TO USE WITH NO DAMAGE OBSERVED. THE INSTRUMENT WAS BEING USED FOR DISSECTING TISSUE. ALL THE FRAGMENTS WERE RETRIEVED DURING SAME PROCEDURE AND CONFIRMED WITH VISUAL INSPECTION. NO ADDITIONAL SURGICAL PROCEDURE WAS REQUIRED TO REMOVE THE FRAGMENT. IT WAS UNKNOWN WHAT CAUSED THE BREAKAGE TO OCCUR AS THE INSTRUMENT DID NOT COLLIDE WITH ANY HARD MATERIALS OR OTHER INSTRUMENTS. THERE WAS NO PATIENT INJURY. THE SURGEON DID NOT NOTICE ANY ISSUES WITH THE FUNCTIONALITY OF THE INSTRUMENT. THE FRAGMENT(S) DID NOT FALL INSIDE THE PATIENT DURING AN INSTRUMENT TIP OR ACCESSORY COLLISION. THE INSTRUMENT WAS NOT REMOVED DURING THE PROCEDURE (PRIOR TO THE BREAKAG

ROSA Robotic Surgery — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT THERE WAS AN INACCURACY OF ALMOST 10 MM FOR A POSTERIOR BIOPSY. BIOPSY WITHOUT OUTCOME, HAD TO BE TAKEN AGAIN.

Mazor X — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: MEDTRONIC RECEIVED INFORMATION REGARDING A GUIDANCE SYSTEM BEING USED DURING A SPINAL PROCEDURE. IT WAS REPORTED THAT THERE WAS A DEVIATION DURING A L3-L4 TLIF PROCEDURE. THE DEVIATION WAS FOUND DURING A POST-OP CT SCAN. THE SCAN SHOWED THAT THE LEFT SIDE SCREWS WERE SHIFTED MEDIAL AND THE RIGHT SIDE SCREWS WERE SHIFTED LATERAL TO PLAN BY 4-6 MM. DURING THE INITIAL PROCEDURE, A SCHANZ PIN WAS PLACED IN THE LEFT PSIS TO MOUNT THE SURGICAL SYSTEM TO THE PATIENT. THE SURGEON PLACED SCREWS WORKING FROM RIGHT TO LEFT STARTING AT L3. THE MANUFACTURER REPRESENTATIVE SUSPECTED THE DEVIATIONS WERE DUE TO A PATIENT SHIFT. A REVISION PROCEDURE WAS DONE TO REVISE THE SCREWS. THE REPRESENTATIVE NOTED THAT IT WAS UNKNOWN IF THERE WERE ANY PATIENT SYMPTOMS RELATED TO THE DEVIATIONS.

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED RADICAL CYSTECTOMY WITH OTHER URINARY DIVERSION SURGICAL PROCEDURE, THE MONOPOLAR CURVED SCISSORS (MCS) TIP COVER FELL OFF THE INSTRUMENT AND INSIDE THE PATIENT'S BODY. THE MCS TIP COVER WAS RETRIEVED AND REPLACED WITH A NEW ONE; HOWEVER, THE SAME ISSUE OCCURRED AGAIN. THE CUSTOMER REPLACED THE MCS INSTRUMENT WITH A BACKUP AND THE MCS TIP COVER NO LONGER FELL OFF THE INSTRUMENT. THE PROCEDURE WAS COMPLETED WITH NO REPORTED INJURY. INTUITIVE SURGICAL, INC. (ISI) FOLLOWED UP WITH THE OPERATING ROOM NURSE AND OBTAINED THE FOLLOWING ADDITIONAL INFORMATION: THE PROCEDURE WAS A TOTAL CYSTECTOMY PERFORM ON (B)(6) 2022. AFTER THE FIRST MCS TIP COVER FELL INSIDE THE PATIENT'S BODY, THE SURGEON QUICKLY RETRIEVED IT WITH AN ASSISTANT FORCEPS. THEN, THE USER INSTALLED A NEW MCS TIP COVER ON THE MCS INSTRUMENT OUTSIDE OF THE PATIENT'S BODY BUT THE MCS TIP COVER SLIPPED OFF EASILY. THE MCS TIP COVER APPEARED TO BE INSTALLED PROPERLY WITH NO VISIBLE ORANGE SURFACE. THE MCS TIP COVER WAS NOT INSTALLED BEYOND THE ORANGE SURFACE THAT WOULD CAUSE A BULGE OVER THE SHAFT. NO INSTALLATION TOOL WAS USED. THE MCS INSTRUMENT WAS EXCHANGED OUT WITH A BACKUP. T

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED NEPHRECTOMY SURGICAL PROCEDURE, THE INTUITIVE SURGICAL, INC. (ISI) CLINICAL SALES REPRESENTATIVE (CSR) STATED THE CUSTOMER LOST THE MONOPOLAR CURVED SCISSORS (MCS) TIP COVER ACCESSORY. THE CSR WANTED TO KNOW IF THE MCS TIP COVER ACCESSORY WAS DETECTABLE BY X-RAY. THE ISI TECHNICAL SUPPORT ENGINEER (TSE) INFORMED CALLER THAT THE MCS TIP COVER ACCESSORY WAS RADIOLUCENT AND THUS CANNOT BE DETECTED BY X-RAY. THE CSR STATED THAT NO INJURY WAS REPORTED AND THAT THE SYSTEM WAS FUNCTIONING PROPERLY. THE PROCEDURE WAS COMPLETED AS PLANNED. ON 31-JAN-2022, ISI OBTAINED THE FOLLOWING INFORMATION FROM THE ROBOTICS COORDINATOR. BOTH THE MCS INSTRUMENT AND THE MCS TIP COVER ACCESSORY WERE INSPECTED BEFORE USE AND NOTHING LOOKED OUT OF THE ORDINARY. THERE WAS NO DAMAGE ON EITHER ITEM. THE MCS TIP COVER ACCESSORY WAS RETRIEVED DURING THE SAME PROCEDURE WITH A LAPAROSCOPIC INSTRUMENT. THERE WAS NO ISSUE WITH THE FUNCTIONALITY OF THE MCS INSTRUMENT. A REDUCER WAS NOT USED FOR THIS INSTRUMENT. THE MCS TIP COVER ACCESSORY FELL OFF WHEN THEY WERE REMOVING THE INSTRUMENT, BUT THEY DID NOT FEEL ANY RESISTANCE WHEN IT WAS BEING REMOVED. SHE WAS NOT SURE IF T

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: ON 25-JAN-2022, INTUITIVE SURGICAL, INC (ISI) RECEIVED USER FACILITY REPORT (B)(4) STATING: "PATIENT WAS UNDERGOING A ROBOTIC ASSISTED LAPAROSCOPIC RIGHT NATIVE NEPHRECTOMY. THE SURGEON USED AN 8 MM SYNCHOSEAL CAUTERY/LIGATION DEVICE. WHEN THE DEVICE WAS REMOVED FROM THE PATIENT, IT WAS NOTED TO BE MISSING A SECTION OF THE GRASPER HOUSING. THE PROVIDER SEARCHED INSIDE THE PATIENT FOR THE FRAGMENT AND AN X-RAY WAS TAKEN. THE X-RAY DID NOT IDENTIFY ANY FOREIGN MATTER, BUT THE RADIOLOGIST NOTED PLASTIC WOULD NOT SHOW UP ON X-RAY." IT WAS ALSO REPORTED BY THE CUSTOMER TO INTUITIVE SURGICAL, INC. (ISI) THAT DURING A DA VINCI-ASSISTED RIGHT NATIVE NEPHRECTOMY SURGICAL PROCEDURE, THE CUSTOMER NOTICED A MISSING SECTION OF THE SYNCRHOSEAL INSTRUMENT WHEN THEY REMOVED IT FROM THE PATIENT. THEY SEARCHED INSIDE THE PATIENT FOR THE FRAGMENT AND AN X-RAY WAS TAKEN. THE X-RAY DID NOT DETECT ANY FOREIGN MATTER, BUT THE RADIOLOGIST NOTED THAT PLASTIC WOULD NOT SHOW UP ON AN X-RAY. ON 04-FEB-2022, ISI CONTACTED ORIGINAL REPORTER FROM THE USER FACILITY REPORT AND OBTAINED THE FOLLOWING ADDITIONAL INFORMATION ABOUT THE COMPLAINT. SHE DID NOT KNOW HOW LONG THE INSTRUMENT WAS IN USE WHEN THE ISSUE OCCUR

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED LIVER RESECTION SURGICAL PROCEDURE, THE JAW FROM A HARMONIC ACE INSTRUMENT BROKE OFF AND FELL INSIDE THE PATIENT. THE FRAGMENT WAS RETRIEVED IN THE SAME PROCEDURE. NO OTHER INFORMATION WAS PROVIDED. ON 01-FEB-2022, INTUITIVE SURGICAL, INC. (ISI) OBTAINED THE FOLLOWING INFORMATION FROM THE ROBOTICS COORDINATOR. THE FRAGMENT WAS RETRIEVED IMMEDIATELY AFTER IT BROKE OFF THE INSTRUMENT USING A LAPAROSCOPIC LOCKING GRASPER. NO POST-OPERATIVE TESTS WERE NEEDED AS THE FRAGMENT WAS LARGE ENOUGH TO SEE. SHE ESTIMATED THAT THE INSTRUMENT WAS IN USE BETWEEN 45 - 60 MINUTES. THE INSTRUMENT WAS INSPECTED BEFORE USE AND NOTHING WAS OUT OF THE ORDINARY. THE INSTRUMENT BROKE WHEN THEY WERE DISSECTING THE LIVER TISSUE. RIGHT BEFORE THE FRAGMENT BROKE, THEY RECEIVED A MESSAGE - RELAX PRESSURE ON JAWS. THERE WAS NO INSTRUMENT COLLISION AND THE INSTRUMENT DID NOT COLLIDE WITH ANY HARD OBJECTS WHILE IN THE PATIENT. THERE WAS NO INJURY TO THE PATIENT AND THE PROCEDURE WAS COMPLETED ROBOTICALLY WITH A NEW HARMONIC INSTRUMENT. THE PATIENT HAS NOT EXPERIENCED ANY ISSUES POST-SURGICAL PROCEDURE. THE INSTRUMENT AND FRAGMENT WAS GIVEN TO THE HOSPITAL RISK MANAGE

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED LIVER RESECTION SURGICAL PROCEDURE, THE HARMONIC ACE INSTRUMENT¿S BLADE BROKE OFF WHILE THE SURGEON WAS MARKING LIVER TISSUE WITH OPENED JAWS. THE INSTRUMENT WAS ONLY IN USE FOR FIVE MINUTES. THE FRAGMENT WAS RETRIEVED IN THE SAME PROCEDURE. THE PROCEDURE WAS COMPLETED WITH NO REPORTED INJURY. INTUITIVE SURGICAL, INC. (ISI) FOLLOWED UP WITH THE INITIAL REPORTER ON 18-JAN-2022 AND OBTAINED THE FOLLOWING ADDITIONAL INFORMATION: THE HARMONIC ACE INSTRUMENT WAS INSPECTED BEFORE THE OPERATION. THE HARMONIC ACE INSTRUMENT DID NOT COLLIDE WITH ANOTHER INSTRUMENT DURING THE OPERATION. THE FRAGMENT WAS RETRIEVED WITH A LAPAROSCOPIC GRASPING FORCEPS. A REPLACEMENT INSTRUMENT WAS USED TO COMPLETE THE SURGERY. THE PATIENT DID NOT SUSTAIN ANY INJURIES AND DID NOT EXPERIENCE ANY POST-OPERATIVE COMPLICATIONS. THE PATIENT¿S CURRENT HEALTH STATUS WAS REPORTED TO BE GOOD. NO POST-OPERATIVE EXAMINATIONS WERE PERFORMED TO LOCATE ANY REMAINING FRAGMENTS. NO PHOTO OR VIDEO WAS SENT TO ISI FOR REVIEW. THE PATIENT DEMOGRAPHICS, RELEVANT TESTS, AND RELEVANT HISTORY WERE NOT PROVIDED.

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED SLEEVE GASTRECTOMY SURGICAL PROCEDURE, A PIECE OF THE SYNCHROSEAL INSTRUMENT WAS SPOTTED RESTING ON THE PATIENT'S STOMACH ALONG THE STAPLE LINE. THE PROCEDURE WAS COMPLETED WITH NO REPORTED INJURY. INTUITIVE SURGICAL, INC. (ISI) CLINICAL SALES REPRESENTATIVE (CSR) PROVIDED THE FOLLOWING ADDITIONAL INFORMATION: THE FRAGMENT WAS RETRIEVED IN THE SAME PROCEDURE BY A GRASPER INSTRUMENT. IT IS UNKNOWN WHEN THE INSTRUMENT BROKE. THEY FOUND THE FRAGMENT NEAR THE STAPLE LINE NEAR THE END OF THE PROCEDURE. THE SYNCHROSEAL DID NOT COLLIDE WITH ANOTHER INSTRUMENT OR HARD OBJECT WHILE INSIDE THE PATIENT. NO POST OPERATIVE TESTS WERE PERFORMED. THERE WAS NO REPORTED POST-OPERATIVE COMPLICATIONS. THE SURGEON DOES NOT KNOW WHAT CAUSED THE ISSUE. THE INSTRUMENT AND FRAGMENT WILL BE RETURNED BACK TO ISI FOR EVALUATION.

ROSA Robotic Surgery — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT FOLLOWING A TKA DONE BY ROSA KNEE SURGICAL INSTRUMENTATION, FEMORAL NOTCHING WAS NOTICED IN THE POST OPERATIVE X-RAYS. NO KNOWN IMPACT OR CONSEQUENCE TO THE PATIENT HAS BEEN REPORTED AT THIS TIME. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED SIGMOIDECTOMY SURGICAL PROCEDURE, THE SYNCHROSEAL INSTRUMENT WAS BROKEN AND A FRAGMENT FELL INSIDE THE PATIENT. THE FRAGMENT WAS RETRIEVED DURING THE SAME PROCEDURE. THE PROCEDURE WAS COMPLETED WITH NO REPORTED INJURY. ON JANUARY 20, 2022 INTUITIVE SURGICAL (IS) CONTACTED THE REPORTER AND OBTAINED THE FOLLOWING ADDITIONAL INFORMATION REGARDING THIS EVENT: THE FIRST ASSISTANT REMOVED THE FRAGMENT WITH A LAPAROSCOPIC INSTRUMENT. THE SURGICAL STAFF DOUBLE CHECKED THE PATIENT'S ANATOMY THEY WERE WORKING ON TO CONFIRM THAT NO FRAGMENT REMAINED. NO ADDITIONAL SURGICAL PROCEDURE WAS REQUIRED. IT WAS NOT NECESSARY TO PERFORM POST-OPERATIVE TESTS LIKE AN X-RAY OR ULTRA SOUND TO CHECK FOR REMAINING FRAGMENTS. AS PER THE SURGEON, THE CAUSE OF THE INSTRUMENT BREAKAGE IS UNKNOWN. THE INSTRUMENT WAS IN USE DURING THE WHOLE THE PROCEDURE. THE INSTRUMENT WAS INSPECTED BY THE NURSE BEFORE THEY HANDED IT TO THE SURGEON. NO DAMAGE WAS NOTICED. NO ISSUE OF THE INSTRUMENT FUNCTIONALITY NOTICED DURING THE SURGICAL PROCEDURE. THE SURGICAL STAFF INDICATED THAT THE INSTRUMENT DID NOT COLLIDE WITH ANOTHER ONE DURING PROCEDURE. THE INSTRUMENT WAS REMOVED WITH N

ROSA Robotic Surgery — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A TKA SURGERY WITH ROSA INSTRUMENTATION, THE DISTAL FEMUR CUT WAS VALIDATED 3MM OVER THE PLANNED RESECTION. THE CUT WAS VALIDATED USING ROSA AND STANDARD CALIPERS. DUE TO THIS OVER-RESECTION OF THE DISTAL FEMUR, THE SURGEON DOWNSIZED BY 2 SIZES TO BALANCE THE SPACE. NO CONSEQUENCES OR IMPACT TO THE PATIENT. IT WAS REPORTED THAT NO FURTHER INFORMATION IS AVAILABLE.

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT AFTER A DA VINCI-ASSISTED SLEEVE GASTRECTOMY SURGICAL PROCEDURE, THE PATIENT EXPERIENCED POSTOPERATIVE BLEEDING. INTUITIVE SURGICAL, INC. (ISI) CONTACTED THE SURGEON AND OBTAINED THE FOLLOWING ADDITIONAL INFORMATION REGARDING THE REPORTED EVENT: ON POST-OPERATIVE DAY #1, THE PATIENT BECAME HYPOTENSIVE AND FELL. AS A RESULT, THE PATIENT ALLEGEDLY BROKE HER VERTEBRAE. THE PATIENT WAS TAKEN BY AMBULANCE TO A NEARBY HOSPITAL (DIFFERENT FROM THE HOSPITAL WHERE THE DA VINCI-ASSISTED SLEEVE GASTRECTOMY WAS PERFORMED). THE PATIENT WAS ADMITTED IN THE ICU. A CT SCAN REVEALED A HEMATOMA. AN ARTERIOGRAM CONFIRMED THERE WAS NO ACTIVE BLEEDING. THE PATIENT UNDERWENT A SECOND PROCEDURE FOR THE BROKEN VERTEBRAE. THE SURGEON REPORTED THAT HE BELIEVES THE POSTOPERATIVE BLEEDING WAS FROM THE RIGHT GASTROEPIPLOIC OR THE SHORT GASTRIC VESSEL AND WAS RELATED TO AN ALLEGED INSUFFICIENT SEAL INVOLVING THE USE OF A SYNCHROSEAL INSTRUMENT. THE SURGEON DOES NOT SKELETONIZE THE VESSELS BEFORE SEALING.

ROSA Robotic Surgery — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED BY A SURGEON THAT FOLLOWING A SURGERY THAT OCCURRED ON (B)(6) 2022 IT WAS NOTICED THAT THE TRAJECTORIES OF THE ELECTRODES WERE NOT ACCURATE AND CAUSED A SUBDURAL HEMORRHAGE. THE PATIENT IS CLINICALLY STABLE.

ROSA Robotic Surgery — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: AT THE BEGINNING OF THE PROCEDURE, THE ROBOT REGISTRATION WENT AS USUAL, THE FRAME REGISTRATION ERROR WAS 0.33 MM AND THE ROBOT REGISTRATION ERROR 0.53 MM. AFTER IMPLANTATION OF THE FIFTH ELECTRODE, I FOUND THAT 4/5 OF THE LENGTHS OF THE ELECTRODES HAD A SYSTEMATIC 5 MM ERROR AND WE TOOK AN O-ARC IMAGE, FROM WHICH IT WAS FOUND THAT ALL BUT ONE ELECTRODE (4/5) WERE 5 MM TOO ANTERIOR TO THE PLAN. THE ELECTRODE, WHICH WAS DESIGNED TO BE ORIENTED, WAS TIPPED SLIGHTLY OBLIQUELY TO THE SKULL BONE, THE MISALIGNED ELECTRODES WERE ALL ORIENTED AT AN ANGLE OF ABOUT 90 DEGREES TO THE SKULL BONE. ANATOMICALLY, HOWEVER, WITH THE EXCEPTION OF ONE ELECTRODE, THE OTHER ELECTRODES APPEARED TO BE STILL IN PLACE. IT WAS DECIDED THAT I MADE A NEW REGISTRATION, AFTER WHICH THE ERROR SEEMED TO BE FIXED. IN A POST-OPERATIVE EXAMINATION, BASED ON THE FUSIONS MADE BY THE PHYSICIST, THE ELECTRODES ARE IN PLACE. AT THE END OF THE PROCEDURE, AN ELECTRODE THAT WAS OUTSIDE THE ANATOMICAL AREA WAS REPLACED. WHEN THE SCREW WAS PLACED IN THE NEW POSITION, NEXT TO THE HOLE IN THE FORMER DRILL, THE THREADS OF THE SCREW CRACK THROUGH THE BONE, THE SCREW SANK INTRACRANIALLY ALONG THE EXTERNAL THREADS AND HAD TO BE REM

Monarch Platform — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A MONARCH-ASSISTED BRONCHOSCOPY PROCEDURE, THE PATIENT EXPERIENCED A PNEUMOTHORAX. THE TARGET LOCATION WAS LEFT UPPER LOBE (LUL) (TARGET IN THE LINGULA), AND THE PNEUMOTHORAX WAS DISCOVERED ON THE RIGHT SIDE WHEN THE PHYSICIAN RECEIVED A RADIAL IMAGE AND DIGITAL RADIOGRAPHY (DX). A CHEST TUBE WAS PLACED AND THE PATIENT WAS ADMITTED TO THE HOSPITAL. THE FOLLOWING DAY THE CHEST TUBE WAS REMOVED AND THE PATIENT WAS RELEASED FROM THE HOSPITAL.

ROSA Robotic Surgery — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT WHILE USING THE ROSA PLATFORM DURING A TKA SURGERY, THERE WAS AN OVER RESECTION OF TIBIA BY 3MM. A THICKER THAN EXPECTED POLY IMPLANT HAD TO BE USED. NO ADDITIONAL CONSEQUENCES OR IMPACT TO THE PATIENT. IT WAS REPORTED THAT NO FURTHER INFORMATION IS AVAILABLE.

Mazor X — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: ABSTRACT: TO COMPARE THE ROBOT TIME/SCREW, RADIATION EXPOSURE, ROBOT ABANDONMENT, SCREW ACCURACY, AND 90-DAY OUTCOMES BETWEEN ROBOT-ASSISTED PERCUTANEOUS AND ROBOT-ASSISTED OPEN APPROACH FOR SHORT LUMBAR FUSION (1-AND 2-LEVEL). THERE IS CONFLICTING LITERATURE ON THE SUPERIORITY OF ROBOT ASSISTED MINIMALLY INVASIVE SPINE SURGERY TO OPEN TECHNIQUES. A LARGE, MULTICENTER STUDY IS NEEDED TO FURTHER ELUCIDATE THE OUTCOMES AND COMPLICATIONS BETWEEN THESE TWO APPROACHES. WE INCLUDED ADULT PATIENTS (=18 YEARS OLD) WHO UNDERWENT ROBOT-ASSISTED SHORT LUMBAR FUSION SURGERY FROM 2015-2019 AT FOUR INDEPENDENT INSTITUTIONS. A PROPENSITY SCORE MATCHING (PSM) ALGORITHM WAS EMPLOYED TO CONTROL FOR THE POTENTIAL SELECTION BIAS BETWEEN PERCUTANEOUS AND OPEN SURGERY. THE MINIMUM FOLLOW-UP WAS 90 DAYS AFTER THE INDEX SURGERY. AFTER PSM, 310 PATIENTS REMAINED. THE MEAN (STANDARD DEVIATION) CHARLSON COMORBIDITY INDEX WAS 1.6 (1.5) AND 53% OF PATIENTS WERE FEMALE. THE MOST COMMON DIAGNOSES INCLUDED HIGH GRADE SPONDYLOLISTHESIS (GRADE >2)(48%), DEGENERATIVE DISC DISEASE (22%), AND SPINAL STENOSIS (25%), AND THE MEAN NUMBER OF INSTRUMENTED LEVELS WAS 1.5 (0.5). THE OPERATIVE TIME WAS LONGER IN THE OPEN (198

Mazor X — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: ABSTRACT: TO COMPARE THE ROBOT TIME/SCREW, RADIATION EXPOSURE, ROBOT ABANDONMENT, SCREW ACCURACY, AND 90-DAY OUTCOMES BETWEEN ROBOT-ASSISTED PERCUTANEOUS AND ROBOT-ASSISTED OPEN APPROACH FOR SHORT LUMBAR FUSION (1-AND 2-LEVEL). THERE IS CONFLICTING LITERATURE ON THE SUPERIORITY OF ROBOT ASSISTED MINIMALLY INVASIVE SPINE SURGERY TO OPEN TECHNIQUES. A LARGE, MULTICENTER STUDY IS NEEDED TO FURTHER ELUCIDATE THE OUTCOMES AND COMPLICATIONS BETWEEN THESE TWO APPROACHES. WE INCLUDED ADULT PATIENTS (=18 YEARS OLD) WHO UNDERWENT ROBOT-ASSISTED SHORT LUMBAR FUSION SURGERY FROM 2015-2019 AT FOUR INDEPENDENT INSTITUTIONS. A PROPENSITY SCORE MATCHING (PSM) ALGORITHM WAS EMPLOYED TO CONTROL FOR THE POTENTIAL SELECTION BIAS BETWEEN PERCUTANEOUS AND OPEN SURGERY. THE MINIMUM FOLLOW-UP WAS 90 DAYS AFTER THE INDEX SURGERY. AFTER PSM, 310 PATIENTS REMAINED. THE MEAN (STANDARD DEVIATION) CHARLSON COMORBIDITY INDEX WAS 1.6 (1.5) AND 53% OF PATIENTS WERE FEMALE. THE MOST COMMON DIAGNOSES INCLUDED HIGH GRADE SPONDYLOLISTHESIS (GRADE >2) (48%), DEGENERATIVE DISC DISEASE (22%), AND SPINAL STENOSIS (25%), AND THE MEAN NUMBER OF INSTRUMENTED LEVELS WAS 1.5 (0.5). THE OPERATIVE TIME WAS LONGER IN THE OPEN (19

Mazor X Robotic Guidance System — Type II recall (initiated 2021-12-16) for software v5.0.1 issues: potential unintended movement of the robotic arm into restricted work-volume areas (emergency stop remained functional), and possible undetected loss of communication between the console computer and the surgical arm causing unexpected arm positioning. One customer complaint of unintended arm movement; zero complaints on the communication-loss issue.

Monarch Platform — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A MONARCH BRONCHOSCOPY PROCEDURE, THE PATIENT DEVELOPED A PNEUMOTHORAX THAT REQUIRED TUBE THORACOSTOMY.

Monarch Platform — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A MONARCH-ASSISTED BRONCHOSCOPY PROCEDURE, THE PATIENT EXPERIENCED A PNEUMOTHORAX. THE TARGET LOCATION WAS RIGHT UPPER LUBE (RUL), AND THE PNEUMOTHORAX WAS DISCOVERED WHEN THE PHYSICIAN USED FLUOROSCOPY AND NOTICED THAT THE PATIENT HAD A PNEUMOTHORAX FROM THE IMAGE. A CHEST TUBE WAS PLACED IN THE PATIENT, AND COUPLE HOURS LATER THE CHEST TUBE WAS REMOVED AND THE PATIENT WAS RELEASED FROM THE HOSPITAL THE SAME DAY.

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED NEPHRECTOMY PROCEDURE THE ENDOSCOPE (SERIAL NUMBER (SN): (B)(4)) EXPERIENCED COMMUNICATION ISSUES WHEN INSTALLED. THE OPERATING ROOM STAFF RESEATED THE ENDOSCOPE WHEN THE ERRORS OCCURRED, BUT THE ISSUE PERSISTED. THE SITE POWER CYCLED THE SYSTEM, AND WHEN THE ENDOSCOPE WAS REINSTALLED THE ERRORS RETURNED. THE PATIENT BEGAN TO BLEED DURING THE TROUBLESHOOTING AND THE SITE CONVERTED TO OPEN RATHER THAN REPLACING THE ENDOSCOPE. THE PATIENT IS REPORTEDLY IN GOOD HEALTH AFTER THIS PROCEDURE. ON 19-JAN-2022, INTUITIVE SURGICAL INC. (ISI) CONTACTED THE SURGEON OF THIS PROCEDURE AND ADDITIONAL INFORMATION WAS OBTAINED ABOUT THE COMPLAINT: THE ENDOSCOPE ISSUES OCCURRED AT THE END OF THE PROCEDURE WHEN THE SURGEON WAS REMOVING THE TUMOR. THE PATIENT'S SPLEEN WAS SCRAPED AND ABOUT 50CC'S OF BLOOD WAS LOST IN TOTAL DUE TO THIS EVENT. THE SURGEON SAID THE BLEEDING WAS RESOLVED BY PLACING PRESSURE ON THE TISSUE.

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT AFTER A DAVINCI-ASSISTED SLEEVE GASTRECTOMY SURGICAL PROCEDURE, THE PATIENT EXPERIENCED POST-OPERATIVE BLEEDING AND RETURNED TO THE FACILITY FOR TREATMENT. INTUITIVE SURGICAL, INC. (ISI) CONTACTED THE SURGEON AND OBTAINED THE FOLLOWING INFORMATION. ON AN UNSPECIFIED POSTOPERATIVE DAY, THE PATIENT PRESENTED WITH HYPOTENSIVE SYMPTOMS. A CT SCAN REVEALED A HEMATOMA. THE SURGEON STATED HE BELIEVES THE POST-OPERATIVE BLEEDING WAS FROM THE RIGHT GASTROEPIPLOIC OR THE SHORT GASTRIC VESSEL AND WAS RELATED TO THE USE OF A SYNCHROSEAL INSTRUMENT ON THOSE VESSELS. THE SURGEON DOES NOT SKELETONIZE THE VESSELS BEFORE SEALING. THE SURGEON STATED HE DOES NOT LIKE HOW THE SYNCHROSEAL CUTS AND HAS TO CUT THE VESSEL MORE THAN ONCE. THE SURGEON INDICATED THAT HE HAS NEVER HAD POST-OPERATIVE BLEEDING INCIDENTS IN HIS PREVIOUS PROCEDURES AND HENCE WILL REVERT TO USING THE VESSEL SEALER EXTEND INSTRUMENT. THE SURGEON CONFIRMED NO SURGICAL INTERVENTION OR BLOOD TRANSFUSIONS WERE RENDERED TO THE PATIENT. HOWEVER, THE PATIENT WAS HOSPITALIZED FOR IV FLUIDS, BLOOD WORK, CT SCAN, AND OBSERVATION.

ROSA Robotic Surgery — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A TKA SURGERY WITH ROSA INSTRUMENTATION, THE PLANNED DISTAL FEMUR CUT WAS 7/9.5MM. THE CUT BONE AND VALIDATED CUT WAS OVER RESECTED AT 10/12.5MM. THERE WAS NO ADDITIONAL IMPACT TO THE PATIENT. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: REFER TO DEVICE MANUFACTUER NARRATIVE FOR FOLLOW-UP INFORMATION.

Mazor X — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: MEDTRONIC RECEIVED INFORMATION REGARDING A GUIDANCE SYSTEM BEING USED DURING A SPINAL PROCEDURE. IT WAS REPORTED THAT THERE WERE DEVIATIONS DURING A SCOLIOSIS CORRECTION PROCEDURE FROM T4-L3. THE LEFT SIDE OF THE PATIENT WAS NOTED TO BE CONCAVE. THE FIRST SEGMENT WAS FROM T10-L3 AND A DISPOSABLE CLAMP WAS PLACED ON THE L1 SPINOUS PROCESS. THERE WAS A MEDIAL BREACH AT LEFT L2. THE DEVIATION WAS CONFIRMED WITH AN O-ARM SCAN AND THE PATIENT'S MEP SIGNALS DROPPED SIGNIFICANTLY OVER TIME AFTER FACETECTOMIES WERE DONE. THE SURGEON BELIEVED THE SEGMENT BECAME MOVABLE AND THE MEDIAL SCREW BRUSHED AGAINST THE SPINAL CORD CAUSING THE DROP IN MOTOR RESPONSES. THE SCREW WAS REMOVED. THE SURFACE OF THE BONE WAS FLATTENED PRIOR TO PLACING THE SCREW. ON THE RIGHT SIDE, THERE WAS SOFT TISSUE PRESSURE ON THE L2 AND L3 TRAJECTORIES THAT RESULTED IN THE SURGEON FREE HANDING THOSE TRAJECTORIES. THE SECOND SEGMENT WAS FROM T4-T9 AND A DUAL CLAMP WAS PLACED AT T6 AND T7. ONLY ONE PORTION OF THE CLAMP WAS USED AND THE OTHER PART WAS LOOSE. ALL SCREWS WERE PLACED ACCURATELY ON THE LEFT SIDE, BUT THERE T4-T5 TRAJECTORIES LOOKED MEDIAL. THE SURGEON DECIDED TO FREEHAND T4 AND T5 RIGHT. THE CAUSE OF THE DEVIA

S6 Robotic Vacuum — Robot vacuum cleaner. The product is sold online, in particular via Amazon. Hazard (Electric shock): The product is supplied with a non-EU (US) connector with a dangerous adapter; when plugged in, high-voltage live parts are accessible. The pins of the adaptor of the power supply are not insulated. The pin ends are neither properly rounded nor tapered. As a consequence, the user could touch live parts and receive an electric shock. The product does not comply with the requirements of the Low ...

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED THYROIDECTOMY SURGICAL PROCEDURE, THE HARMONIC ACE INSTRUMENT WAS FOUND TO HAVE THE TEFLON PAD MELTED, AND FRAGMENTS WERE FALLING INSIDE THE PATIENT. THE FRAGMENTS WERE NOT RETRIEVED. THE CUSTOMER REMOVED THE INSTRUMENT AND USED A BACKUP INSTRUMENT TO COMPLETE THE PROCEDURE. INTUITIVE SURGICAL, INC. (ISI) FOLLOWED UP WITH THE INITIAL REPORTER AND OBTAINED THE FOLLOWING ADDITIONAL INFORMATION: THE INSTRUMENT WAS INSPECTED PRIOR TO USE WITH NO DAMAGE OBSERVED. THE TEFLON PAD MELTED LIKE POWDER AS SOON AS THE CUSTOMER STARTED TO USE THE INSTRUMENT. THE FRAGMENTS WERE NOT RETRIEVED AS THEY WERE NOTED TO BE "LIKE POWDER." IT WAS UNKNOWN WHAT CAUSED THE MELTING TO OCCUR AS THE INSTRUMENT DID NOT COLLIDE WITH ANY HARD MATERIALS OR OTHER INSTRUMENTS, AND THE CUSTOMER CONFIRMED THAT ARCING WAS NOT OBSERVED. THE THYROID TISSUE DID NOT APPEAR TO BE TOO THICK. THE SURGEON DID NOT NOTICE ANY ISSUES WITH THE FUNCTIONALITY OF THE INSTRUMENT. NO POST-OPERATIVE TESTS LIKE AN X-RAY OR ULTRASOUND WERE PERFORMED, AND NO ADDITIONAL SURGICAL PROCEDURE WAS PERFORMED. THE PATIENT HAS NOT RETURNED TO THE HOSPITAL DUE TO EXPERIENCING ANY POST-SURGICAL COMPLICA

ROSA Robotic Surgery — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A TKA SURGERY WITH ROSA INSTRUMENTATION THE TIBIA WAS OVER-RESECTED BY 2MM MEDIALLY AND 3.5MM LATERALLY. DUE TO THIS DEVIATION FROM THE SURGICAL PLAN, A 16MM TIBIAL IMPLANT WAS NEEDED WHEN A 10MM IMPLANT WAS PLANNED. PATIENT HAD NO IMPACT AND WAS NOT AFFECTED. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED LIVER RESECTION SURGICAL PROCEDURE, HALF OF THE TIP FROM A HARMONIC ACE INSTRUMENT BROKE OFF IN THE ABDOMINAL CAVITY DURING LIVER RESECTION. THE FRAGMENT WAS RETRIEVED IN THE SAME PROCEDURE. NO OTHER INFORMATION WAS PROVIDED. ON (B)(6) 2022, INTUITIVE SURGICAL, INC. (ISI) OBTAINED THE FOLLOWING INFORMATION FROM THE ROBOTICS COORDINATOR. THE SURGEON WAS USING THE HARMONIC ACE INSTRUMENT DURING A PARTIAL LIVER RESECTION. THE CASE WAS ALMOST COMPLETED, BUT THE FRAGMENT BROKE DURING DISSECTION. THE TEAM NOTICED THIS WHEN THE SURGEON WAS MOVING THE INSTRUMENT TO A DIFFERENT AREA OF THE LIVER. THIS CAUSED A 20-30 MINUTE DELAY IN THE CASE. THE FRAGMENT WAS FOUND AND REMOVED FROM THE PATIENT DURING THE SAME PROCEDURE BY USING A LAPAROSCOPIC GRASPER. IT WAS CONFIRMED TO BE REMOVED VISUALLY SO NOT POST-OPERATIVE TESTS WERE NEEDED. BOTH THE FRAGMENT AND THE INSTRUMENT HAVE BEEN GIVEN TO RISK MANAGEMENT. THE CASE WAS LATER CONVERTED TO AN OPEN PROCEDURE DUE TO PATIENT ANATOMY AND NOT DUE TO THE MALFUNCTION OF THE INSTRUMENT.

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED MALIGNANT HYSTERECTOMY PROCEDURE, THE PANCREAS WAS INJURED DURING THE INSERTION OF THE AIR-SEAL PORT IN A PATIENT WITH A SMALL BODY HABITUS. INTUITIVE SURGICAL, INC. (ISI) FOLLOWED UP WITH THE SURGEON AND OBTAINED THE FOLLOWING INFORMATION: THE SOURCE OF BLEEDING WAS PANCREATIC TISSUE, WHICH WAS DAMAGED WHEN A THIRD-PARTY AIRSEAL PORT WAS INSERTED IN THE PATIENT. THE BLEEDING WAS INITIALLY STOPPED BY APPLYING COMPRESSION AND HEMOSTATIC POWDER. THE SURGEON BELIEVES THAT THE CAUSE OF THE PANCREATIC INJURY WAS DUE TO THE PETITE STATURE OF THE PATIENT AND THE CEPHALAD DIRECTION OF THE INSERTION OF THE AIRSEAL PORT. ACCORDING TO THE SURGEON, THERE WAS NO MALFUNCTION OF AN ISI PRODUCT THAT CAUSED THE PANCREATIC INJURY. AT THE END OF THE PROCEDURE, THE PANCREATIC INJURY, THAT WAS SUSTAINED DURING PORT PLACEMENT, BEGAN TO RE-BLEED. A HEPATOBILIARY PANCREATIC SURGEON WAS CALLED INTO THE OPERATION TO SUTURE THE PANCREAS TO ACHIEVE HEMOSTASIS. THE SURGEON BELIEVES THAT THE CAUSE OF THE RE-BLEEDING WAS DUE TO A PSEUDOANEURYSM FORMED DURING TISSUE DAMAGE, SUTURING, OR DECREASE IN THE INSUFFLATION PRESSURE. NO ADDITIONAL TISSUE RESECTION WAS REQUIR

ROSA Robotic Surgery — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A TKA SURGERY USING ROSA INSTRUMENTATION, THE TIBIA WAS OVER-RESECTED BY 3MM POSTERIOR-LATERAL. THIS WAS VALIDATED USING CALIPERS. TISSUE RELEASES AND BONE RECUTS HAD TO BE MADE TO BALANCE THE KNEE. A THICKER POLY HAD TO BE USED THAN WOULD HAVE BEEN THE CASE IF ROSA HAD CORRECTLY CUT THE REQUIRED AMOUNT OF BONE. THERE WAS NO ADDITIONAL PATIENT IMPACT REPORTED. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

ExcelsiusGPS — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT A PATIENT EXPERIENCED ADVERSE EFFECTS FOLLOWING SURGERY WHERE A SCREW WAS MISPLACED INTRA-OPERATIVELY.

Monarch Platform — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: THE FOLLOWING MEDICAL LITERATURE WAS REVIEWED: ROBOTIC BRONCHOSCOPY: FACTORS ASSOCIATED WITH DIAGNOSTIC ACCURACY OF ROBOTIC BRONCHOSCOPY WITH 12-MONTH FOLLOW-UP: AUTHORS: ABHINAV AGRAWAL, MD, ELLIOT HO, DO, UDIT CHADDHA, MBBS, BARIS DEMIRKOL, MD, SIVASUBRAMANIUM V. BHAVANI, MD, D. KYLE HOGARTH, MD, FCCP, SEPTIMIU MURGU, MD, FCCP. CITATION:DOI:HTTPS://DOI.ORG/10.1016/J.ATHORACSUR.2021.12.041. IT WAS REPORTED PNEUMOTHORAX AND PATIENT HOSPITALIZE . NO DEVICE ISSUES WERE REPORTED.

ROSA Robotic Surgery — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: CONCERNING THE 3 BIOPSIES PERFORMED, THE PROCEDURE DID NOT POSE ANY PARTICULAR PROBLEM, THE FIXATION WAS WITH A MAYFIELD HEAD HOLDER IN CLASSIC DECUBITUS, THERE WAS NO HEMORRHAGIC COMPLICATION OBJECTIFIED AT THE POSTOPERATIVE CONTROL CT SCAN. ON THE OTHER HAND, THE ANALYSIS OF THE SAMPLES WAS NEGATIVE, REQUIRING A SECOND SURGICAL INTERVENTION TO OBTAIN THE DIAGNOSIS, AND THEREFORE A DELAY IN ONCOLOGICAL MANAGEMENT OF ABOUT ONE MONTH.

Mazor X — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: ABSTRACT: MANAGEMENT OF DEGENERATIVE DISEASE OF THE SPINE HAS EVOLVED TO FAVOR MINIMALLY INVASIVE TECHNIQUES, INCLUDING NONROBOTIC-ASSISTED AND ROBOTIC-ASSISTED MINIMALLY INVASIVE TRANSFORAMINAL LUMBAR INTERBODY FUSION (MIS-TLIF). VALUE-BASED SPENDING IS BEING INCREASINGLY IMPLEMENTED TO CONTROL RISING COSTS IN THE US HEALTHCARE SYSTEM. WITH AN AGING POPULATION, IT IS FUNDAMENTAL TO UNDERSTAND WHICH PROCEDURE(S) MAY BE MOST COST-EFFECTIVE. TO COMPARE ROBOTIC AND NONROBOTIC MIS-TLIF THROUGH A COST-UTILITY ANALYSIS. WE CONSIDERED DIRECT MEDICAL COSTS RELATED TO SURGICAL INTERVENTION AND TO THE HOSPITAL STAY, AS WELL AS 1-YR UTILITIES. WE ESTIMATED COSTS BY ASSESSING ALL CASES INVOLVING ADULTS UNDERGOING ROBOTIC SURGERY AT A SINGLE INSTITUTION AND AN EQUAL NUMBER OF PATIENTS UNDERGOING NONROBOTIC SURGERY, MATCHED BY DEMOGRAPHIC AND CLINICAL CHARACTERISTICS. WE ADOPTED A WILLINGNESS TO PAY OF $50 000/QUALITY-ADJUSTED LIFE YEAR (QALY). UNCERTAINTY WAS ADDRESSED BY DETERMINISTIC AND PROBABILISTIC SENSITIVITY ANALYSES. COSTS WERE ESTIMATED BASED ON A TOTAL OF 76 PATIENTS, INCLUDING 38 UNDERGOING ROBOT-ASSISTED AND 38 MATCHED PATIENTS UNDERGOING NONROBOTIC MIS-TLIF. USING POINT ESTIMATES,

ROSA Robotic Surgery — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING AN INITIAL ROSA INSTRUMENTATION TKA SURGERY BOTH ROSA AND CALIPER VALIDATIONS CONFIRMED THAT THE TIBIA WAS OVER-RESECTED BY 4MM MEDIALLY AND 3MM LATERALLY. THERE WAS NO ADDITIONAL PATIENT IMPACT REPORTED. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

ROSA Robotic Surgery — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A TKA PROCEDURE WHILE USING ROSA INSTRUMENTATION, THERE WAS AN OVER RESECTION FROM PLANNED TIBIAL CUT OF 6MM. A 16MM INLAY WAS USED AND THE KNEE WAS STABLE AND WELL BALANCED. AS OF THIS REPORT SUBMISSION THERE HAS BEEN NO ADDITIONAL PATIENT IMPACT REPORTED. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Husqvarna Automower 435X AWD and Automower 535 AWD robotic lawnmowers — Battery may degrade after roughly 1,450 charging cycles and overheat, creating a fire risk. No injuries in Canada or the US; 5 international incidents where the malfunction damaged equipment. Husqvarna offered free battery replacement to units with 1,200+ cycles and two free software updates via the Automower Connect App to prevent degradation.

ROSA Robotic Surgery — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A TKA UTILIZING ROSA INSTRUMENTATION THE TIBIA WAS OVER RESECTED BOTH MEDIALLY AND LATERALLY 4MM. CALIPERS WERE USED TO VERIFY THAT EXCESSIVE BONE REMOVAL HAD OCCURRED. NO KNOWN IMPACT OR CONSEQUENCE TO THE PATIENT. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

ROSA Robotic Surgery — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A ROSA TKA SURGERY THE 4-IN-1 CUT WAS NOT ACCURATE AND LED TO AN OVER-RESECTION. THE OVER-RESECTION WAS ENOUGH TO NOTCH THE FEMUR. THERE WAS NO ADDITIONAL PATIENT IMPACT REPORTED. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Today, the Toronto City Council voted to ban sidewalk robots until the council has the opportunity to further study the effects they have on the community.

Monarch Platform — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A MONARCH-ASSISTED BRONCHOSCOPY PROCEDURE THE PATIENT EXPERIENCED A PNEUMOTHORAX. THE TARGET LOCATION WAS RIGHT UPPER LUBE (RUL), AND THE PNEUMOTHORAX WAS DISCOVERED DURING POST-PROCEDURE CHEST X-RAY. A CHEST TUBE WAS PLACED IN THE PATIENT AND THE PATIENT WAS ADMITTED TO THE HOSPITAL. THE CHEST TUBE WAS REMOVED FOUR DAYS AFTER THE PLACEMENT AND THE PATIENT WAS DISCHARGED.

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: IT WAS REPORTED THAT DURING A DA VINCI-ASSISTED ESOPHAGECTOMY TRANSTHORACIC-NECK ANASTOMOSIS SURGICAL PROCEDURE, A PIECE OF HARMONIC ACE INSTRUMENT BROKE INSIDE THE PATIENT. THE BROKEN PIECE WAS RETRIEVED DURING THE SAME PROCEDURE. THE CUSTOMER USED A BACKUP INSTRUMENT. THE PROCEDURE WAS COMPLETED WITH NO REPORTED PATIENT INJURY. INTUITIVE SURGICAL, INC. (ISI) FOLLOWED UP WITH THE INITIAL REPORTER (NURSE) AND OBTAINED ADDITIONAL INFORMATION: THE CUSTOMER DID NOT NOTICE ANY DAMAGE ON THE INSTRUMENT PRIOR TO USE. THE BROKEN PIECE WAS RETRIEVED WITH A LAPAROSCOPIC GRASPER INSTRUMENT. NO POST-OPERATIVE TESTS WERE PERFORMED. THE SURGEON DID NOT NOTICE ANY ISSUES WITH THE FUNCTIONALITY OF THE INSTRUMENT. THE INSTRUMENT DID NOT COLLIDE WITH ANY OTHER INSTRUMENTS OR OTHER HARD MATERIAL DURING THE SURGICAL PROCEDURE.

Mazor X — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: ABSTRACT: ROBOTICS IS A MAJOR AREA FOR RESEARCH AND DEVELOPMENT IN SPINE SURGERY. THE HIGH ACCURACY OF ROBOT-ASSISTED PLACEMENT OF THORACOLUMBAR PEDICLE SCREWS IS DOCUMENTED IN THE LITERATURE. THE AUTHORS PRESENT THE LARGEST CASE SERIES TO DATE EVALUATING 90-DAY COMPLICATION, REVISION, AND READMISSION RATES FOR ROBOT-ASSISTED SPINE SURGERY USING THE CURRENT GENERATION OF ROBOTIC GUIDANCE SYSTEMS. AN ANALYSIS OF A RETROSPECTIVE, MULTICENTER DATABASE OF OPEN AND MINIMALLY INVASIVE THORACOLUMBAR INSTRUMENTED FUSION SURGERIES USING THE MAZOR X OR MAZOR X STEALTH EDITION ROBOTIC GUIDANCE SYSTEMS WAS PERFORMED. PATIENTS 18 YEARS OF AGE OR OLDER AND UNDERGOING PRIMARY OR REVISION SURGERY FOR DEGENERATIVE SPINAL CONDITIONS WERE INCLUDED. DESCRIPTIVE STATISTICS WERE USED TO CALCULATE RATES OF MALPOSITIONED SCREWS REQUIRING REVISION, AS WELL AS OVERALL COMPLICATION, REVISION, AND READMISSION RATES WITHIN 90 DAYS. IN TOTAL, 799 SURGICAL CASES (MAZOR X: 48.81%; MAZOR X STEALTH EDITION: 51.19%) WERE EVALUATED, INVOLVING ROBOT-ASSISTED PLACEMENT OF 4838 PEDICLE SCREWS. THE OVERALL INTRAOPERATIVE COMPLICATION RATE WAS 3.13%. NO INTRAOPERATIVE IMPLANT-RELATED COMPLICATIONS WERE ENCOUNTERED. POSTOP

da Vinci Surgical System — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: REFER TO H10/H11 FOR FOLLOW-UP INFORMATION.

Mako Robotic-Arm — Injury report filed with FDA (MAUDE). A MAUDE report does not establish that the device caused the outcome. Reported narrative: NO NEW INFORMATION.