FDA Adverse Event Malfunction Summary report: N

ELEFANT SUCTION-IRRIGATION DEVICE

MDR report key: 17615577 · Received August 24, 2023

Report

Report Number
9610711-2023-00187
Event Type
Malfunction
Date Received
August 24, 2023
Report Date
January 15, 2024
Manufacturer
COLOPLAST A/S
Product Code
FQH
UDI-DI
03600040320501
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

AFTER RECEIVING THIS COMPLAINT, WE SEARCHED FOR OTHER COMPLAINT AND WE DIDN¿T FIND OTHER COMPLAINT ON THE LOT NUMBER 801131. CHECKING THE QUALITY DATABASES REVEALED NO ANOMALY IN CONNECTION WITH THE DESCRIBED DEFECT. ON JULY WE RECEIVED ONE SEALED SAMPLE. AFTER OBSERVATION WE NOTED THAT A HAIR WAS INSIDE THIS PACKAGING. ON OCTOBER, A RESENSITIZATION WAS PERFORMED IN THE ELEFANT AREA IN THE WORKSHOP WITH THE OPERATORS CONCERNED (SEE IN INVESTIGATION THE PROOF OF RESENSITIZATION).

Additional Manufacturer Narrative · 0

WITHOUT THE BENEFIT OF EXAMINATION AND TESTING, COLOPLAST IS PRECLUDED FROM COMMENTING ON THE CONDITION OF THE DEVICE OR THE CAUSE OF THE OCCURRENCE. SHOULD ADDITIONAL FACTS PROMPT US TO ALTER OR SUPPLEMENT ANY INFORMATION OR CONCLUSIONS CONTAINED IN THE ORIGINAL MDR OR IN ANY PRIOR SUPPLEMENTAL REPORTS, A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 0

ACCORDING TO AVAILABLE INFORMATION, THIS DEVICE HAD A FOREIGN MATERIAL IN THE PRIMARY PACKAGING. THE MATERIAL WAS FOUND BEFORE THE PACKAGE WAS OPENED. NO OTHER ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

ACCORDING TO AVAILABLE INFORMATION, THIS DEVICE HAD A FOREIGN MATERIAL IN THE PRIMARY PACKAGING. THE MATERIAL WAS FOUND BEFORE THE PACKAGE WAS OPENED. NO OTHER ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2122308 ELEFANT SUCTION-IRRIGATION DEVICE SURGICAL IRRIGATION/ASPIRATION CANNULA, NON-ILLUMINATING, SINGLE-USE FQH COLOPLAST A/S 8011314_ASP1901002 03600040320501

Patients

Seq Age Sex Outcome Treatment
1 Unknown