FDA Adverse Event Injury Summary report: N

ION

MDR report key: 18263678 · Received December 4, 2023

Report

Report Number
2955842-2023-20680
Event Type
Injury
Date Received
December 4, 2023
Date of Event
October 2, 2023
Report Date
November 13, 2023
Manufacturer
INTUITIVE SURGICAL, INC
Product Code
EOQ
UDI-DI
00886874116234
PMA / PMN Number
K182188
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

BASED ON THE INFORMATION PROVIDED, THE ROOT CAUSE OF THE CUSTOMER REPORTED COMPLICATION CANNOT BE DETERMINED. THERE IS NO ALLEGATION THAT A MALFUNCTION OF AN ION SYSTEM, INSTRUMENT, OR ACCESSORY OCCURRED. A REVIEW OF THE SYSTEM LOGS FOR THE REPORTED PROCEDURE DATE SHOWED THERE WERE NO RELATED SYSTEM ERRORS TO HAVE OCCURRED DURING THE PROCEDURE THAT WOULD HAVE LIKELY CAUSED OR CONTRIBUTED TO THE REPORTED EVENT.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT AN ION ENDOLUMINAL LUNG BIOPSY PROCEDURE AND DEVELOPED A PNEUMOTHORAX REQUIRING A CHEST TUBE AND HOSPITALIZATION. THE PATIENT HAD 3 LESIONS BIOPSIED: RIGHT LOWER LOBE (2.2CM), LEFT LOWER LOBE (1CM), AND RIGHT MIDDLE LOBE (1.8CM). THE DIAGNOSIS OBTAINED FROM PATHOLOGY WAS ADENOCARCINOMA (MALIGNANT). THERE IS NO ALLEGATION THAT A MALFUNCTION OF AN ION SYSTEM, INSTRUMENT, OR ACCESSORY OCCURRED. INTUITIVE SURGICAL INC. (ISI) HAS MADE MULTIPLE ATTEMPTS TO OBTAIN ADDITIONAL INFORMATION; HOWEVER, AS OF THE DATE OF THIS REPORT, NO NEW INFORMATION HAS BEEN OBTAINED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2047797 ION SYSTEM CART EOQ INTUITIVE SURGICAL, INC 380748-61 UNKNOWN 00886874116234

Patients

Seq Age Sex Outcome Treatment
1 Unknown ION ENDOLUMINAL SYSTEM.