FDA Adverse Event
Malfunction
Summary report: N
BAYLIS MEDICAL COMPANY RADIOFREQUENCY PUNCTURE GENERATOR
MDR report key: 12367885
·
Received August 25, 2021
Report
- Report Number
- 9710452-2021-00041
- Event Type
- Malfunction
- Date Received
- August 25, 2021
- Date of Event
- July 28, 2021
- Report Date
- August 25, 2021
- Product Code
- GEI
- UDI-DI
- 00685447000969
- PMA / PMN Number
- K122278
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- GA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 0
THERE WAS NO PATIENT IMPACT OR CONSEQUENCE. BAYLIS MEDICAL COMPANY INC. HAS DECIDED TO REPORT THIS EVENT DUE TO THE PROCEDURAL DELAY THAT OCCURRED. DHR REVIEW WAS COMPLETED AND THE DEVICE FULFILLED ALL REQUIREMENTS PRIOR TO RELEASE.
Description of Event or Problem · 0
A 20-MINUTE PROCEDURAL DELAY WAS REPORTED IN A CASE WHERE THE BAYLIS RADIOFREQUENCY PUNCTURE GENERATOR WAS NOT RECOGNIZING THE GROUNDING PAD. THE ISSUE WAS RESOLVED WHEN ANOTHER GENERATOR WAS USED FOR THE PROCEDURE. WHILE THERE WAS NO PATIENT INJURY REPORTED, BAYLIS MEDICAL COMPANY INC. HAS DECIDED TO REPORT THIS EVENT DUE TO THE PROCEDURAL DELAY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1266129 | BAYLIS MEDICAL COMPANY RADIOFREQUENCY PUNCTURE GENERATOR | RADIOFREQUENCY GENERATOR | GEI | RFP-100A | 00685447000969 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |