FDA Adverse Event Malfunction Summary report: N

4K LAPAROSCOPE, 30 DEG, 10 X 330MM

MDR report key: 19483762 · Received June 7, 2024

Report

Report Number
1220246-2024-05190
Event Type
Malfunction
Date Received
June 7, 2024
Date of Event
May 2, 2022
Report Date
June 7, 2024
Manufacturer
ARTHREX, INC.
Product Code
GCJ
UDI-DI
00888867029729
PMA / PMN Number
K941541
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 0

THIS 3500A RECORD IS SUBMITTED TO COMPLY WITH AN FDA 483 INSPECTIONAL OBSERVATION ISSUED TO ARTHREX INC ON MAY 5, 2023. ARTHREX HAS REASSESSED THE REPORTABILITY DECISIONS MADE ON HISTORICAL COMPLAINT RECORDS USING REVISED CRITERION. THIS 3500A DOCUMENT IS A RESULT OF THE REASSESSMENT. EVENT DESCRIPTION: IT WAS REPORTED THAT THE OPTICS IS SHARP-EDGED. THE REPORTED EVENT WAS CONFIRMED AS THE VISUAL EVALUATION REVEALED THE DISTAL END IS SHARP-EDGED DUE TO THE FACT THAT THE KEEL IS PROTRUDING OUT OF THE DISTAL ENDS. COMPLAINANT¿S EVENT IS TYPICALLY CAUSED IF THE CHANGING TEMPERATURES BUILT UP STRESS ON THE ENTIRE ENDOSCOPES DURING USAGE TIME THE HEATING AND COOLING DURING REPROCESSING LEADS TO EXTENSION AND CONTRACTION OF THE DIFFERENT MATERIALS. THIS STRESS CAN BE THE REASON FOR THE KEEL TO PROTRUDE OUT OF THE DISTAL END. FURTHER THE SHAFT IS SLIGHTLY BEND, THE DISTAL END HAS SCRATCHES AND THE ATTACHMENT FOR THE LIGHT GUIDE CABLE HAS SIGNS OF BURNS CAUSED BY EXCESSIVE HEAT. THE MOST LIKELY CAUSE FOR THE REPORTED FAILURE CAN BE ATTRIBUTED TO MISUSE/MISHANDLING DUE TO THE DAMAGE TO THE DEVICE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE OPTICS IS SHARP-EDGED. THERE WAS NO HARM FOR THE PATIENT, OPERATOR OR THIRD PARTY REPORTED. NO FURTHER INFORMATION RECEIVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1436661 4K LAPAROSCOPE, 30 DEG, 10 X 330MM LAPAROSCOPE GCJ ARTHREX, INC. 4K LAPAROSCOPE, 30 DEG, 10 X 330MM 00888867029729

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown