FDA Adverse Event Malfunction Summary report: N

ENDOCARE CRYOCARE CRYOPROBE, R1.7MM R/ANGLE

MDR report key: 2054116 · Received March 2, 2011

Report

Report Number
3008262715-2011-00004
Event Type
Malfunction
Date Received
March 2, 2011
Date of Event
February 11, 2011
Report Date
February 11, 2011
Manufacturer
HEALTHTRONICS, INC.
Product Code
GEH
PMA / PMN Number
K060279
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE RETURNED PROBE WAS VISUALLY AND FUNCTIONALLY EVALUATED AND THE ISSUE WAS CONFIRMED. THE SHAFT FROSTED DUE TO A VACUUM FAILURE. DEVICE HISTORY REVIEW SHOWED THERE WAS ONE RELATED ISSUE WITH FINAL ASSEMBLY LOT #09-0594. THE VACUUM TUBE LOT, USED IN THE FINAL ASSEMBLY, HAD BEEN 100% TESTED WITH NO FAILURES REPORTED.

Description of Event or Problem · 1

DURING PRETEST CYCLE, ICE FORMED ON THE ENTIRE SHAFT OF THE CRYOPROBE. TEST WAS TERMINATED AND THE PROBE WAS REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDOCARE CRYOCARE CRYOPROBE, R1.7MM R/ANGLE UNIT, CRYOSURGICAL, ACCESSORIES GEH HEALTHTRONICS, INC. R1.7 09-0633

Patients

Seq Age Sex Outcome Treatment
1