FDA Adverse Event Injury Summary report: N

SUPERDIMENSION BRONCHUS SYSTEM (SDBS)

MDR report key: 1600563 · Received February 10, 2010

Report

Report Number
3004962788-2010-00007
Event Type
Injury
Date Received
February 10, 2010
Date of Event
January 12, 2010
Report Date
February 10, 2010
Manufacturer
SUPERDIMENSION INC.
Product Code
JAK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

PNEUMOTHORAX IS A KNOWN COMPLICATION WHEN A LUNG BIOPSY IS PERFORMED DURING A TRANSBRONCHIAL LUNG BIOPSY, OR CT-GUIDED PERCUTANEOUS BIOPSY WITH COMPLICATION RATES UP TO APPROXIMATELY 27% WITH THE CT GUIDED PROCEDURE. BIOPSY TOOLS ARE DESIGNED TO HAVE SHARP EDGES AND THEIR FUNCTION IS TO PUNCTURE OR OTHERWISE PENETRATE THE TISSUE IN ORDER TO COLLECT A SPECIMEN.

Description of Event or Problem · 1

THE SITE REPORTED THAT THEY HAD A SUPERDIMENSION CASE IN WHICH THE PT DEVELOPED A PNEUMOTHORAX. IT WAS REPORTED THAT A CHEST TUBE WAS PLACED AND THE PT WAS RELEASED FROM THE HOSPITAL THE NEXT DAY WITH NO FURTHER COMPLICATIONS. THERE WAS NO ALLEGATION THAT THE SUPERDIMENSION SYSTEM CAUSED THE REPORTED PNEUMOTHORAX.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SUPERDIMENSION BRONCHUS SYSTEM (SDBS) COMPUTED TOMOGRAPHY X-RAY SYSTEM JAK SUPERDIMENSION INC.

Patients

Seq Age Sex Outcome Treatment
1 35 YR Hospitalization