FDA Adverse Event Malfunction Summary report: N

ENDOSCOPIC BILIARY CATHETER

MDR report key: 2010988 · Received March 8, 2011

Report

Report Number
3005099803-2011-00729
Event Type
Malfunction
Date Received
March 8, 2011
Date of Event
February 18, 2011
Report Date
February 21, 2011
Manufacturer
BOSTON SCIENTIFIC - SPENCER
Product Code
LQR
PMA / PMN Number
K946358
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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.

Additional Manufacturer Narrative · 1

A VISUAL EXAMINATION OF THE RETURNED DEVICE FOUND THAT THE EXPOSED CUTTING WIRE WAS INTACT BUT DISCOLORED FROM USE. THE CUTTING WIRE WAS MEASURED AND FOUND TO BE WITHIN SPECIFICATION AND A FUNCTIONAL EVALUATION FOUND THE DEVICE TO BOW WITHIN SPECIFICATION. A SECOND FUNCTIONAL EVALUATION OF THE CONTINUITY BETWEEN THE 2-IN-1 CONNECTOR AND THE EXPOSED CUTTING WIRE FOUND THE DEVICE TO BE ABLE TO CONDUCT CURRENT INDICATING PROPER CONNECTIVITY OF THE DEVICE. THE 2-IN-1 CONNECTOR WAS INTACT AND AN ACTIVE CORD CONNECTOR COULD BE CONNECTED TO THE 2-IN-1 CONNECTOR WITHOUT ANY ISSUES. THE RESISTANCE ACROSS THE 2-IN-1 CONNECTED AND THE CUTTING WIRE WAS MEASURED AND FOUND TO BE WITHIN SPECIFICATION. THE CONDITION OF THE RETURNED INCIDENT DEVICE WAS NOT CONSISTENT WITH THE COMPLAINT THAT THE CONNECTING PART OF THE DEVICE WAS EXTENDED AND IT WAS UNABLE TO APPLY ELECTRIC CURRENT TO THE DEVICE. THE COMPLAINT WAS NOT CONFIRMED. A SEARCH OF THE COMPLAINT DATABASE REVEALED THAT NO SIMILAR COMPLAINTS EXIST FOR THE SPECIFIED LOT. THE DEVICE HISTORY RECORD REVIEW FOUND THE DEVICE MET ALL MANUFACTURING SPECIFICATIONS.

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A STONETOME SPHINCTEROTOME WAS TO BE USED DURING AN ENDOSCOPIC SPHINCTEROTOMY (EST) PROCEDURE. ACCORDING TO THE COMPLAINANT, DURING THE PROCEDURE, THE ACTIVE CORD CONNECTOR COULD NOT BE FITTED ONTO THE ACTIVE CORD. NO VISIBLE DAMAGE WAS NOTED TO THE CONNECTOR. THE CONNECTOR WAS EXTENDED/FLARED IN ORDER TO CONNECT THE DEVICE TO THE ACTIVE CORD. HOWEVER, ELECTRICAL CURRENT WAS UNABLE TO BE APPLIED TO THE SPHINCTEROTOME. THE PROCEDURE WAS COMPLETED USING ANOTHER STONETOME SPHINCTEROTOME IN CONJUNCTION WITH THE SAME ACTIVE CORD. 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 STONETOME SPHINCTEROTOME WAS TO BE USED DURING AN ENDOSCOPIC SPHINCTEROTOMY (EST) PROCEDURE. ACCORDING TO THE COMPLAINANT, DURING THE PROCEDURE, THE ACTIVE CORD CONNECTOR COULD NOT BE FITTED ONTO THE ACTIVE CORD. NO VISIBLE DAMAGE WAS NOTED TO THE CONNECTOR. THE CONNECTOR WAS EXTENDED/FLARED IN ORDER TO CONNECT THE DEVICE TO THE ACTIVE CORD. HOWEVER, ELECTRICAL CURRENT WAS UNABLE TO BE APPLIED TO THE SPHINCTEROTOME. THE PROCEDURE WAS COMPLETED USING ANOTHER STONETOME SPHINCTEROTOME IN CONJUNCTION WITH THE SAME ACTIVE CORD. 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 ENDOSCOPIC BILIARY CATHETER DISLODGER, STONE, BILIARY LQR BOSTON SCIENTIFIC - SPENCER M00535110 13812638

Patients

Seq Age Sex Outcome Treatment
1