FDA Adverse Event Injury Summary report: N

AQUABEAM ROBOTIC SYSTEM

MDR report key: 14432008 · Received May 18, 2022

Report

Report Number
3012977056-2022-00050
Event Type
Injury
Date Received
May 18, 2022
Date of Event
January 25, 2021
Report Date
May 17, 2022
Manufacturer
PROCEPT BIOROBOTICS CORPORATION
Product Code
PZP
UDI-DI
B6142201011
PMA / PMN Number
DEN170024
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
LE
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

A REVIEW OF THE AQUABEAM ROBOTIC SYSTEM'S LOG FILE COULD NOT BE CONDUCTED AS THE DATE WHEN THE AQUABLATION PROCEDURE TOOK PLACE IS UNKNOWN. A REVIEW OF THE DEVICE HISTORY RECORD (DHR) FOR SERIAL NUMBER (B)(4) WAS PERFORMED, WHICH CONFIRMED THAT THERE WERE NO NONCONFORMANCES, FAILURES, DISCREPANCIES, OR MISSED STEPS DURING THE MANUFACTURING PROCESS THAT COULD BE RELATED TO THE REPORTED EVENT. THE REVIEW INDICATED THAT THE DEVICE MET ALL DESIGN AND MANUFACTURING SPECIFICATIONS WHEN RELEASED FOR DISTRIBUTION. AQUABEAM ROBOTIC SYSTEM USER MANUAL, UM220101, WAS REVIEWED AND STATES THE FOLLOWING: PROCEDURE: AS WITH ANY SURGICAL UROLOGIC PROCEDURE, POTENTIAL RISKS OF THE AQUABLATION PROCEDURE INCLUDE: O URINARY RETENTION. A HISTORICAL REVIEW FOR SIMILAR COMPLAINTS CONFIRMED 11 OTHER SIMILAR EVENTS FOR URINARY RETENTION HAVE BEEN REPORTED TO PROCEPT BIOROBOTICS. A ROOT CAUSE FOR THE REPORTED EVENT COULD NOT BE DETERMINED. THE AQUABEAM ROBOTIC SYSTEM USER MANUAL LISTS URINARY RETENTION AS A POTENTIAL RISK OF THE AQUABLATION PROCEDURE. NO DEVICE MALFUNCTION WAS REPORTED OR CONFIRMED THROUGH THE INVESTIGATION PERFORMED BY PROCEPT. SUBMISSION OF THIS REPORT DOES NOT CONSTITUTE AN ADMISSION THAT THE MANUFACTURER'S PRODUCT CAUSED OR CONTRIBUTED TO THE EVENT.

Description of Event or Problem · 0

ON 18-APRIL-2022, PROCEPT BIOROBOTICS CORPORATION BECAME AWARE OF AN ARTICLE PUBLISHED ON 25-JAN-2021 IN THE INVESTIGATE AND CLINICAL UROLOGY (ICUROLOGY) THAT INCLUDED DETAILS OF 14 ADVERSE EVENTS REPORTED WITH PATIENTS WITHIN 90 DAYS OF UNDERGOING AN AQUABLATION PROCEDURE. MOST PROCEDURAL-RELATED ADVERSE EVENTS WERE CLASSIFIED AS CLAVIEN-DINDO GRADE 1 OR GRADE 2. THIS REPORT IS BEING SUBMITTED FOR ONE OF THE FOUR (4) EVENTS CLASSIFIED AS CLAVIEN-DINDO 1 DUE TO ACUTE URINARY RETENTION REQUIRING PROLONGED CATHETERIZATION. NO GRADE 4B OR GRADE 5 COMPLICATIONS WERE NOTED. NO DEVICE MALFUNCTION WAS REPORTED DURING THESE PROCEDURES. THE MANUFACTURER'S USER MANUAL LIST URINARY RETENTION AS A POTENTIAL RISK OF THE AQUABLATION PROCEDURE. ALL PERTAINING INFORMATION AVAILABLE TO PROCEPT BIOROBOTIC IS BEING SUBMITTED WITH THIS REPORT. THIS IS REPORT 4 OF 13.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2763002 AQUABEAM ROBOTIC SYSTEM FLUID JET REMOVAL SYSTEM PZP PROCEPT BIOROBOTICS CORPORATION B6142201011

Patients

Seq Age Sex Outcome Treatment
1 Male Required Intervention