FDA Adverse Event Malfunction Summary report: N

EXAMINE CHOLANGIOGRAPHY CATHETERS

MDR report key: 1259525 · Received December 9, 2008

Report

Report Number
1320894-2008-00166
Event Type
Malfunction
Date Received
December 9, 2008
Date of Event
October 1, 2008
Report Date
December 9, 2008
Manufacturer
CONMED CORPORATION
Product Code
GBZ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE COMPLAINT WAS REPORTED BY CONMED DISTRIBUTOR (B) (4) WHO REPORTED THE USER FACILITY AS (B) (4). CONMED IS AWARE THAT THE 30 DAY TIMEFRAME HAS BEEN MISSED BY 5 DAYS; CONMED IS FILING IMMEDIATELY UPON THE DISCOVERY OF THIS OVERSIGHT. THE PRODUCT HAS BEEN RETURNED TO CONMED FOR EVALUATIONS AND ONCE THE INVESTIGATION REPORT IS COMPLETE, A SUPPLEMENTAL REPORT WILL BE FILED.

Description of Event or Problem · 1

IT WAS REPORTED BY A DISTRIBUTOR THAT "DISCONNECTION AT OUTER TUBE LEVEL. THE INNER TUBE REMAINED IN THE CYSTIC CANAL. THEY TRIED TO RE-INSERT THE INNER TUBE, WHICH LED A LESION DOWNSTREAM OF CYSTIC CANAL. THIS COULD BE INJURIOUS FOR THE PT, THIS OCCURRED TWICE WITH 2 DIFFERENT OPERATORS WITH THE SAME BATCH NUMBER."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EXAMINE CHOLANGIOGRAPHY CATHETERS PERCUTANEOUS INTRODUCTION CATHETER GBZ CONMED CORPORATION NA 0803241

Patients

Seq Age Sex Outcome Treatment
1