FDA Adverse Event Injury Summary report: N

AQUABEAM ROBOTIC SYSTEM

MDR report key: 18841650 · Received March 5, 2024

Report

Report Number
3012977056-2024-00042
Event Type
Injury
Date Received
March 5, 2024
Date of Event
January 9, 2024
Report Date
March 5, 2024
Manufacturer
PROCEPT BIOROBOTICS CORPORATION
Product Code
PZP
UDI-DI
00860009122918
PMA / PMN Number
DEN170024
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE AQUABEAM ROBOTIC SYSTEM IS A REUSABLE DEVICE; THEREFORE, IT IS STILL CURRENTLY IN POSSESSION OF THE USER FACILITY. THE INVESTIGATION OF THIS EVENT CONSISTED OF A REVIEW OF THE DEVICE HISTORY RECORD (DHR), AND LABELING. A REVIEW OF THE DEVICE HISTORY RECORD (DHR) WAS CONDUCTED FOR SERIAL NUMBER (B)(6), 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 SYSTEM MET ALL DESIGN AND MANUFACTURING SPECIFICATIONS WHEN RELEASED FOR DISTRIBUTION. THE AQUABEAM ROBOTIC SYSTEM INSTRUCTIONS FOR USE (IFU) - JAPAN, IFU0107-00, REV. A, WAS REVIEWED AND STATES THE FOLLOWING: 4.3. WARNINGS: PROCEDURE: AS WITH ANY SURGICAL UROLOGIC PROCEDURE, POTENTIAL PERIOPERATIVE RISKS OF THE AQUABLATION PROCEDURE INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING, SOME OF WHICH MAY LEAD TO SERIOUS OUTCOMES AND MAY REQUIRE INTERVENTION: URETHRAL DAMAGE CAUSING FALSE PASSAGE OR STRICTURE. A ROOT CAUSE FOR THE REPORTED EVENT COULD NOT BE DETERMINED. THE AQUABEAM ROBOTIC SYSTEM'S IFU LISTS URETHRAL DAMAGE CAUSING FALSE PASSAGE OR STRICTURE AS A POTENTIAL RISK OF THE AQUABLATION PROCEDURE. BASED ON THE REVIEW OF THE EVENT DETAILS, DHR, AND IFU THE EVENT IS CONSIDERED NOT TO BE DEVICE-RELATED. 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

A MALE PATIENT UNDERWENT AN AQUABLATION PROCEDURE FOR SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA (BPH). PROCEPT BIOROBOTICS CORPORATION (PROCEPT) BECAME AWARE THAT THE PATIENT HAD EXPERIENCED URETHRAL STRICTURE. AN URETHRAL DILATION PROCEDURE WAS DONE IN THE OUTPATIENT CLINIC TO ADDRESS THE ISSUE. THE EVENT WAS REPORTED AS MILD AND NON-SERIOUS. THE REPORTED EVENT WAS CONSIDERED RELATED TO THE PROCEDURE. NO MALFUNCTION OF THE AQUABEAM ROBOTIC SYSTEM WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
196257 AQUABEAM ROBOTIC SYSTEM FLUID JET REMOVAL SYSTEM PZP PROCEPT BIOROBOTICS CORPORATION 00860009122918

Patients

Seq Age Sex Outcome Treatment
1 NA Male Required Intervention