FDA Adverse Event Malfunction Summary report: N

ELECTROSURGICAL GENERATOR "ESG-400"

MDR report key: 10231857 · Received July 6, 2020

Report

Report Number
9610773-2020-00149
Event Type
Malfunction
Date Received
July 6, 2020
Date of Event
June 30, 2020
Report Date
July 17, 2020
Manufacturer
OLYMPUS WINTER & IBE GMBH
Product Code
GEI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

THE SUSPECT MEDICAL DEVICE WAS NOT RETURNED TO THE MANUFACTURER FOR INVESTIGATION/EVALUATION. THEREFORE, THE MANUFACTURER'S EVALUATION WAS EXCLUSIVELY PERFORMED ON THE BASIS OF THE PROVIDED INFORMATION. ACCORDING TO THE AVAILABLE DOCUMENTATION, ERROR MESSAGE E433 OCCURRED WHICH IS TRIGGERED BY THE GENERATOR¿S SAFETY SYSTEM. IN CASE OF CRITICAL ERRORS, THE SAFETY SYSTEM WILL NOT PERMIT ANY FURTHER USE OF THE GENERATOR UNTIL THE ERROR IS RECTIFIED. IN THE CASE AT HAND, THIS WAS MOST LIKELY CAUSED BY A DEFECTIVE TRANSFORMER TR1 ON THE GENERATOR BOARD. THEREFORE, THIS EVENT/INCIDENT WAS ATTRIBUTED TO COMPONENT FAILURE. HOWEVER, A MANUFACTURING AND QUALITY CONTROL REVIEW WAS PERFORMED FOR THE AFFECTED SERIAL NUMBER OF THE ELECTROSURGICAL GENERATOR WITHOUT SHOWING ANY ABNORMALITIES. FURTHERMORE, A DETAILED RISK ASSESSMENT REGARDING THIS ISSUE WAS PERFORMED AND THE RISK TO PATIENTS, USERS, AND/OR THIRD PARTIES WAS EVALUATED AS ACCEPTABLE. THE CASE WILL BE CLOSED FROM OLYMPUS SIDE WITH NO FURTHER ACTIONS BUT THE REPORTED EVENT/INCIDENT WILL BE RECORDED FOR TRENDING AND SURVEILLANCE PURPOSES. IN ADDITION, THE USER WILL BE INFORMED ABOUT THE INVESTIGATION RESULTS.

Additional Manufacturer Narrative · 1

THE SUSPECT MEDICAL DEVICE HAS NOT YET BEEN RETURNED TO OLYMPUS FOR EVALUATION/INVESTIGATION. THEREFORE, THE EXACT CAUSE OF THE USER'S EXPERIENCE AND THE REPORTED PHENOMENON COULD NOT BE DETERMINED AND IS BEING JUDGED AS UNKNOWN. HOWEVER, IF THE SUSPECT MEDICAL DEVICE IS RETURNED FOR EVALUATION/INVESTIGATION OR ADDITIONAL SIGNIFICANT INFORMATION BECOMES AVAILABLE, THIS REPORT WILL BE UPDATED. PLEASE NOTE: THIS REPORT IS BEING SUBMITTED ALTHOUGH THE SUSPECT MEDICAL DEVICE IS NOT MARKETED IN THE USA. HOWEVER, A SIMILAR DEVICE IS MARKETED. MODEL # / CATALOG #: WB91051W; BRAND NAME: HF UNIT "ESG-400"; COMMON DEVICE NAME: HF- GENERATORS; 510(K): K141225; PRODUCT CODE: GEI.

Description of Event or Problem · 1

OLYMPUS WAS INFORMED THAT DURING A THERAPEUTIC GASTRECTOMY PROCEDURE, THE ESG-400 HF-GENERATOR EMITTED SMOKE AND ISSUED ERROR MESSAGE E433. THE INTENDED PROCEDURE WAS COMPLETED USING A SIMILAR DEVICE AND THERE WAS NO REPORT ABOUT AN ADVERSE EVENT OR PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
698442 ELECTROSURGICAL GENERATOR "ESG-400" HF-GENERATORS GEI OLYMPUS WINTER & IBE GMBH WB91051C

Patients

Seq Age Sex Outcome Treatment
1