FDA Adverse Event Malfunction Summary report: N

TRAPEZOID RX LITHOTRIPTER COMPATIBLE BASKET, MODELS 1086, 1087, 1088

MDR report key: 1934842 · Received December 21, 2010

Report

Report Number
3005099803-2010-05151
Event Type
Malfunction
Date Received
December 21, 2010
Report Date
November 25, 2010
Manufacturer
BOSTON SCIENTIFIC - SPENCER
Product Code
LQC
PMA / PMN Number
K040447
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

NO CODE AVAILABLE (BASKET WON'T CLOSE). THE DEVICE HAS BEEN RECEIVED FOR ANALYSIS. UPON COMPLETION OF THE FAILURE ANALYSIS OF THE COMPLAINT DEVICE, IF THERE IS ANY FURTHER RELEVANT INFORMATION FROM THAT REVIEW, A SUPPLEMENTAL MEDWATCH WILL BE FILED. (B)(4).

Additional Manufacturer Narrative · 1

A VISUAL EXAMINATION OF THE RETURNED DEVICE FOUND HEAVY BLACK RESIDUE ON THE DEVICE INDICATING USE AND THE BASKET WAS IN THE RETRACTED POSITION. THE GUIDEWIRE LUMEN (SIDE-CAR) WAS PRESENTED PUSH-BACK AND THE SHEATH WAS FOUND TO BE BUCKLED IN MULTIPLE AREAS. FUNCTIONALLY THE BASKET FAILED TO EXTEND PROPERLY DUE TO THE HEAVY BLACK RESIDUE AND SCRATCHES ON THE HANDLE CANNULA WHICH CAUSED INTERFERENCE BETWEEN THE CANNULA AND THE HANDLE ASSEMBLY. THE CONDITION OF THE RETURNED INCIDENT DEVICE WAS CONSISTENT WITH THE COMPLAINT THAT THE DEVICE BASKET WON'T CLOSE. HEAVY CONTRAST RESIDUE AND SCRATCHES FOUND ON THE HANDLE CANNULA CREATED FRICTION AND PREVENTED SMOOTH FUNCTION OF THE DEVICE. SINCE THERE ARE CONTROLS IN THE MANUFACTURING PROCESS THAT VERIFY PRODUCT INTEGRITY, THE SPECIFIC CAUSE OF THE FAILURE CANNOT BE IDENTIFIED. IT IS LIKELY THAT THE DEVICE WAS DAMAGED DURING THE PROCEDURE; HOWEVER A DEFINITIVE ROOT CAUSE OF THE DAMAGE COULD NOT BE DETERMINED. A REVIEW OF THE DEVICE HISTORY RECORD (DHR) WAS PERFORMED; NO ANOMALIES WERE NOTED. A SEARCH OF THE COMPLAINT DATABASE REVEALED THAT NO SIMILAR COMPLAINTS EXIST FOR THE SPECIFIED LOT. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A TRAPEZOID RX LITHOTRIPTER COMPATIBLE BASKET WAS USED DURING A REMOVAL OF A COMMON BILE DUCT STONES PROCEDURE. ACCORDING TO THE COMPLAINANT, DURING THE PROCEDURE, AFTER SUCCESSFULLY CAPTURING/CRUSHING STONES, THE PHYSICIAN ATTEMPTED TO CAPTURE A 1CM STONE BUT WAS UNABLE TO. AFTER THE FOURTH ATTEMPT THE BASKET WAS UNABLE TO BE CLOSED. THE STONE WAS FINALLY REMOVED ALONG WITH THE DEVICE AND SCOPE, EVEN THOUGH THE BASKET WAS UNABLE TO BE CLOSED, AND THE PROCEDURE WAS COMPLETED. IT COULD NOT BE REPORTED WHETHER ANY DEVICE DAMAGE WAS NOTED AFTER USE, HOWEVER, THE DEVICE WAS INSPECTED/TESTED PRIOR TO USE AND NO ANOMALIES WERE NOTED. THERE WERE NO PATIENT COMPLICATIONS REPORTED AS A RESULT OF THIS EVENT. THE PATIENT'S CONDITION AT THE CONCLUSION OF THE PROCEDURE WAS REPORTED TO BE GOOD.

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A TRAPEZOID RX LITHOTRIPTER COMPATIBLE BASKET WAS USED DURING A REMOVAL OF A COMMON BILE DUCT STONES PROCEDURE. ACCORDING TO THE COMPLAINANT, DURING THE PROCEDURE, AFTER SUCCESSFULLY CAPTURING/CRUSHING STONES, THE PHYSICIAN ATTEMPTED TO CAPTURE A 1CM STONE BUT WAS UNABLE TO. AFTER THE FOURTH ATTEMPT THE BASKET WAS UNABLE TO BE CLOSED. THE STONE WAS FINALLY REMOVED ALONG WITH THE DEVICE AND SCOPE, EVEN THOUGH THE BASKET WAS UNABLE TO BE CLOSED, AND THE PROCEDURE WAS COMPLETED. IT COULD NOT BE REPORTED WHETHER ANY DEVICE DAMAGE WAS NOTED AFTER USE, HOWEVER, THE DEVICE WAS INSPECTED/TESTED PRIOR TO USE AND NO ANOMALIES WERE NOTED. THERE WERE NO PATIENT COMPLICATIONS REPORTED AS A RESULT OF THIS EVENT. THE PATIENT'S CONDITION AT THE CONCLUSION OF THE PROCEDURE WAS REPORTED TO BE GOOD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TRAPEZOID RX LITHOTRIPTER COMPATIBLE BASKET, MODELS 1086, 1087, 1088 LITHOTRIPTOR, BILIARY MECHANICAL LQC BOSTON SCIENTIFIC - SPENCER M00510890 13418961

Patients

Seq Age Sex Outcome Treatment
1