FDA Adverse Event Malfunction Summary report: N

HF UNIT "ESG-400"

MDR report key: 10967521 · Received December 8, 2020

Report

Report Number
9610773-2020-00289
Event Type
Malfunction
Date Received
December 8, 2020
Report Date
January 14, 2021
Manufacturer
OLYMPUS WINTER & IBE GMBH
Product Code
GEI
UDI-DI
04042761076838
PMA / PMN Number
K141225
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PO
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

DEVICE EVALUATION: THE SUSPECT MEDICAL DEVICE WAS NOT RETURNED TO THE MANUFACTURER FOR INVESTIGATION/EVALUATION BUT TO OLYMPUS IBERIA (OIB). THE EVALUATION/INVESTIGATION AT OIB CONFIRMED THE OCCURRENCE OF ERROR E433. THIS ERROR MESSAGE, WHICH IN THE CASE AT HAND WAS CAUSED BY A DEFECT OF THE GENERATOR BOARD, 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. 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. 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.

Description of Event or Problem · 1

OLYMPUS WAS INFORMED THAT DURING A THERAPEUTIC TRANSURETHRAL RESECTION OF THE PROSTATE (TURP) PROCEDURE AT AN UNKNOWN DATE, THE ESG-400 GENERATOR ISSUED ERROR MESSAGE E433. NO FURTHER INFORMATION WAS PROVIDED BUT THERE WAS NO REPORT ABOUT AN ADVERSE EVENT OR PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1430931 HF UNIT "ESG-400" HF-GENERATORS GEI OLYMPUS WINTER & IBE GMBH WB91051W 04042761076838

Patients

Seq Age Sex Outcome Treatment
1