FDA Adverse Event Malfunction Summary report: N

TX SYSTEM - TX2 MICROTIP

MDR report key: 19602032 · Received June 24, 2024

Report

Report Number
1000135560-2024-00027
Event Type
Malfunction
Date Received
June 24, 2024
Date of Event
December 28, 2023
Report Date
June 24, 2024
Manufacturer
TENEX HEALTH, INC.
Product Code
LFL
UDI-DI
00857156006154
PMA / PMN Number
K153299
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SD, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THE INCIDENT WAS INITIALLY MISREPORTED TO TENEX HEALTH, INC. ON JANUARY 9, 2024 AS A DIFFERENT NON MDR-REPOTRABLE ISSUE. LATER COMMUNICATION WITH THE REPORTER ON JUNE 14, 2024 REVEALED THIS WAS A NEEDLE BREAK, A REPORTABLE MALFUNCTION.

Description of Event or Problem · 0

DURING A PROCEDURE WITH THE TENEX SYSTEM, A PORTION OF THE MICROTIP NEEDLE SEPARATED FROM THE REST OF THE HANDPIECE. THE PROCEDURE WAS C OMPLETED WITH ANOTHER MICROTIP. THERE WERE NO PATIENT COMPLICATIONS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1019593 TX SYSTEM - TX2 MICROTIP INSTRUMENT, ULTRASONIC SURGICAL LFL TENEX HEALTH, INC. 554-2003-001 2892301 00857156006154

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown