FDA Adverse Event Malfunction Summary report: N

HYRDOTHERMABLATOR CONSOLE UNIT

MDR report key: 1221507 · Received November 5, 2008

Report

Report Number
3005099803-2008-05943
Event Type
Malfunction
Date Received
November 5, 2008
Date of Event
August 22, 2008
Report Date
October 6, 2008
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
MNB
PMA / PMN Number
P000040
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE SUSPECT DEVICE HAS NOT BEEN RECEIVED FOR EVALUATION; THEREFORE, THE CAUSE OF THE REPORTED MALFUNCTION IS CURRENTLY UNDETERMINED. UPON COMPLETION OF THE FAILURE ANALYSIS OF THE COMPLAINT DEVICE, IF THERE IS ANY FURTHER RELEVANT INFORMATION FROM THAT REVIEW, A SUPPLEMENTAL MEDWATCH WILL BE FILED.

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION IN 2008, HYDROTHERMABLATOR (HTA) CONSOLE UNIT WAS USED DURING A THERAPEUTIC HYDROTHERMAL ABLATION PROCEDURE IN 2008. ACCORDING TO THE COMPLAINANT, THE PRODUCT FAILED, MACHINE SHUT DOWN AT START OF ABLATION. THERE IS NO FURTHER INFORMATION AVAILABLE REGARDING THE PATIENT OR THE EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HYRDOTHERMABLATOR CONSOLE UNIT MNB BOSTON SCIENTIFIC CORPORATION M006560000 NA

Patients

Seq Age Sex Outcome Treatment
1 UNK