FDA Adverse Event Malfunction Summary report: N

FLEXIVA ID

MDR report key: 15013260 · Received July 14, 2022

Report

Report Number
15013260
Event Type
Malfunction
Date Received
July 14, 2022
Date of Event
June 27, 2022
Report Date
June 30, 2022
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
GEX
Product Problem
Yes
Report Source
User Facility report
Reporter Location
ME
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Description of Event or Problem · 0

NARRATIVE FROM STAFF: DURING OUR CASE, WE OPENED A FLEXIVA ID 1000 AND PLUGGED END INTO LASER MACHINE. THE MACHINE HAD A CIRCLE THAT KEPT CIRCLING BUT WOULD NOT LOAD/READ IT. WE HAD PREVIOUSLY USED THE 550 LASER AND IT WORKED FINE SO IT WASN'T THE LASER MACHINE. WE UNPLUGGED THE 1000 ONE AND PLUGGED THE 550 ONE BACK IN AND IT READ FINE AND WERE ABLE TO USE IT. THIS FLEXIVA ID 1000 CAME DEFECTIVE.

Description of Event or Problem · 0

NARRATIVE FROM STAFF: DURING OUR CASE, WE OPENED A FLEXIVA ID 1000 AND PLUGGED END INTO LASER MACHINE. THE MACHINE HAD A CIRCLE THAT KEPT CIRCLING BUT WOULD NOT LOAD/READ IT. WE HAD PREVIOUSLY USED THE 550 LASER AND IT WORKED FINE SO IT WASN'T THE LASER MACHINE. WE UNPLUGGED THE 1000 ONE AND PLUGGED THE 550 ONE BACK IN AND IT READ FINE AND WERE ABLE TO USE IT. THIS FLEXIVA ID 1000 CAME DEFECTIVE.

Description of Event or Problem · 0

NARRATIVE FROM STAFF: DURING OUR CASE, WE OPENED A FLEXIVA ID 1000 AND PLUGGED END INTO LASER MACHINE. THE MACHINE HAD A CIRCLE THAT KEPT CIRCLING BUT WOULD NOT LOAD/READ IT. WE HAD PREVIOUSLY USED THE 550 LASER AND IT WORKED FINE SO IT WASN'T THE LASER MACHINE. WE UNPLUGGED THE 1000 ONE AND PLUGGED THE 550 ONE BACK IN AND IT READ FINE AND WERE ABLE TO USE IT. THIS FLEXIVA ID 1000 CAME DEFECTIVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1955297 FLEXIVA ID POWERED LASER SURGICAL INSTRUMENT GEX BOSTON SCIENTIFIC CORPORATION M006R8403940 0000010893

Patients

Seq Age Sex Outcome Treatment
1 Unknown