FDA Adverse Event Malfunction Summary report: N

MOTIVA FLORA TISSUE EXPANDER

MDR report key: 19651799 · Received July 1, 2024

Report

Report Number
3012883202-2024-00026
Event Type
Malfunction
Date Received
July 1, 2024
Date of Event
March 7, 2024
Report Date
July 1, 2024
Manufacturer
MOTIVA USA LLC
Product Code
LCJ
PMA / PMN Number
K211676
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CS
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

AFTER ANALYZING THE REPORT, THE PORT LOCATION FAILURE WAS NOT CONFIRMED BECAUSE THE DEVICE WAS NOT RECEIVED. A COMPLETE REVIEW OF THE DHR FOR LOT 23090959 WAS CARRIED OUT, NO DEVIATION WAS FOUND IN THE MANUFACTURING PROCESS. ADDITIONALY, A REVIEW OF COMPLAINT HISTORY FOR THE REPORTED LOT NUMBER AND STERILIZATION RUN FOUND NO OTHER SIMILAR COMPLAINTS REPORTED IN THE PAST. DIRECTIONS FOR USE REVIRE: EACH PATIENT SHOULD BE GIVEN THE ESTABLISHMENT LABS ¿MOTIVA FLORA® TISSUE EXPANDER: INFORMATION FOR THE PATIENT¿ DOCUMENT DURING HER SURGICAL CONSULTATION. IT IS THE SURGEON¿S RESPONSIBILITY TO ENSURE THAT THIS HAPPENS, AND IT IS A REQUIREMENT FOR THE USE OF THE DEVICE. THE PATIENT MUST BE GIVEN ENOUGH TIME TO READ AND COMPLETELY UNDERSTAND THE INFORMATION REGARDING THE RISKS, BENEFITS, AND RECOMMENDATIONS ASSOCIATED WITH TISSUE EXPANDER-BASED BREAST RECONSTRUCTION SURGERY. IN ORDER TO DOCUMENT A SUCCESSFUL INFORMED CONSENT PROCESS, THE PATIENT, A WITNESS, AND THE SURGEON SHOULD SIGN THE ¿INFORMED CONSENT DOCUMENT,¿ WHICH WILL BE PART OF THE PATIENT¿S MEDICAL FILE. THE INSTRUCTIONS FOR USE IN THE DIRECTIONS FOR USE WERE REVIEWED, TO DETERMINATE IF THERE ARE INDICATIONS THAT ENSURE THE PREVENTION AND GOOD HANDLING OF THE PRODUCT. FOR THIS EVENT, IT IS CONSIDERED THAT THE INFORMATION IS SUITABLE FOR THE SECTION OF SURGICAL PRECAUTIONS AS FOLLOWS: THE MOTIVA FLORA® TISSUE EXPANDER MUST BE FILLED VIA AN INTEGRATED PORT, WHICH IS FOUND VIA AN EXTERNAL MOTIVA FLORA® PORT LOCATOR THROUGH THE RFID SIGNAL EMITTED BY THE AIR WOUND COIL PLACED INSIDE THE NEEDLE STOP. THE AIR WOUND COIL IS INTENDED TO INTERACT WITH THE PORT LOCATOR TO IDENTIFY THE LOCATION OF THE INJECTION PORT MOTIVA FLORA® TISSUE EXPANDER CONTAINS A RFID TRANSPONDER THAT PROVIDES AN ELECTRONIC SERIAL NUMBER (ESN) THAT IS UNIQUE TO EACH DEVICE, SO IT CAN BE MATCHED TO A DATABASE OF INTERNAL RECORDS FOR TRACEABILITY. THE USE OF AN RFID SIGNAL TO IDENTIFY THE CENTER OF THE INJECTION PORT IS AN INNOVATIVE TECHNOLOGY NOT AVAILABLE IN OTHER TISSUE EXPANDERS ON THE MARKET. MALFUNCTION OF THE EXPANDER IN THE EARLY POSTOPERATIVE PERIOD IS RARE. PROPER PLACEMENT OF THE EXPANDER AND CONFIRMATION OF PORT PATENCY AFTER SKIN CLOSURE DURING THE OPERATIVE PROCEDURE SHOULD BE SUFFICIENT TO AVOID NEED FOR ANY REVISION SURGERY. A MOTIVA FLORA® PORT LOCATOR IS REQUIRED TO LOCATE THE INJECTION SITE. IT IS AN EXTERNAL REUSABLE DEVICE THAT USES RFID TECHNOLOGY WHICH IS COMPATIBLE ONLY WITH THE MOTIVA FLORA® TISSUE EXPANDER. WHILE THE INJECTION SITE CAN BE GENERALLY IDENTIFIED BY PALPATION, TO AVOID BREAST TISSUE EXPANDER PERFORATION ALWAYS VERIFY AND CONFIRM ITS LOCATION USING THE MOTIVA FLORA® PORT LOCATOR BEFORE EACH FILLING. AT ESTABLISHMENT LABS, WE ARE COMMITTED TO PATIENT SAFETY AND CONTINUALLY EVALUATE THE PERFORMANCE OF OUR DEVICES THROUGH POST-MARKET SURVEILLANCE OF REPORTED COMPLAINTS & ADVERSE EVENTS.

Description of Event or Problem · 0

IT WAS REPORTD THAT THERE WAS A FAILURE TO RECOGNIZE THE INJCTION PORT BY THE LOCATOR AT THE TIME OF FILLING THE EXPANDER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
572842 MOTIVA FLORA TISSUE EXPANDER MOTIVA FLORA TISSUE EXPANDER LCJ MOTIVA USA LLC 23090959

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown