FDA Adverse Event Malfunction Summary report: N

SNAPLOC WIRE GUIDE LOCKING DEVICE

MDR report key: 20653853 · Received November 11, 2024

Report

Report Number
1037905-2024-00708
Event Type
Malfunction
Date Received
November 11, 2024
Date of Event
October 17, 2024
Report Date
November 11, 2024
Manufacturer
WILSON-COOK MEDICAL INC
Product Code
ODC
UDI-DI
00827002596832
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

PMA/510(K) # K213483. INVESTIGATION EVALUATION: A PRODUCT EVALUATION WAS NOT PERFORMED IN RESPONSE TO THIS REPORT BECAUSE THE PRODUCT SAID TO BE INVOLVED WAS NOT PROVIDED TO COOK FOR EVALUATION. THE REPORT COULD NOT BE CONFIRMED. A PHOTO OF THE PRODUCT LABELING WAS PROVIDED. THE LOT NUMBER PROVIDED IN THE PHOTO MATCHES THIS REPORT. THE LABEL IN THE PHOTO MATCHES THE PRODUCT REPORTED. THE DEVICE HISTORY RECORD FOR THE LOT NUMBER SAID TO BE INVOLVED WAS REVIEWED. A DISCREPANCY OR ANOMALY WAS NOT OBSERVED WITH THE PRODUCT THAT WAS RELEASED FOR DISTRIBUTION. INVESTIGATION CONCLUSION: WE COULD NOT CONDUCT A COMPLETE INVESTIGATION BECAUSE THE PRODUCT SAID TO BE INVOLVED WAS NOT RETURNED FOR EVALUATION. A DEFINITIVE CAUSE FOR THE REPORTED OBSERVATION COULD NOT BE DETERMINED. PRIOR TO DISTRIBUTION, ALL SNAPLOC WIRE GUIDE LOCKING DEVICES ARE SUBJECTED TO A VISUAL INSPECTION AND FUNCTIONAL TESTING TO ENSURE DEVICE INTEGRITY. A REVIEW OF THE DEVICE HISTORY RECORD CONFIRMED THAT THE LOT SAID TO BE INVOLVED MET ALL MANUFACTURING REQUIREMENTS PRIOR TO SHIPMENT. CORRECTIVE ACTION: CORRECTIVE ACTION IS NOT WARRANTED AT THIS TIME BASED ON THE QUALITY ENGINEERING RISK ASSESSMENT. QUALITY ASSURANCE WILL CONTINUE TO MONITOR FOR COMPLAINT TRENDS AND REASSESS THE RISK ASSESSMENT RESULTS AS POST MARKET FEEDBACK CONTINUES TO BECOME AVAILABLE.

Description of Event or Problem · 0

DURING AN ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP) PROCEDURE, THE PHYSICIAN USED A COOK SNAPLOC WIRE GUIDE LOCKING DEVICE. IT WAS REPORTED THAT THE PHYSICIAN EXPERIENCED AN ISSUE WITH THE LOCK¿THE WIRE KEPT SLIPPING. IT¿S IMPORTANT TO NOTE THAT THEY WERE USING THE OLYMPUS VISIGLIDE WIRE, WHICH IS THEIR STANDARD WIRE IN GALWAY, A SECTION OF THE DEVICE DID NOT REMAIN INSIDE THE PATIENT¿S BODY. THE PATIENT DID NOT REQUIRE ANY ADDITIONAL PROCEDURES DUE TO THIS OCCURRENCE. ACCORDING TO THE INITIAL REPORTER, THE PATIENT DID NOT EXPERIENCE ANY ADVERSE EFFECTS DUE TO THIS OCCURRENCE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1568400 SNAPLOC WIRE GUIDE LOCKING DEVICE ODC ENDOSCOPE CHANNEL ACCESSORY ODC WILSON-COOK MEDICAL INC G59683 W4839740 00827002596832

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown OLYMPUS SCOPE, MODEL UNKNOWN| OLYMPUS VISIGLIDE WIRE GUIDE