FDA Adverse Event Malfunction Summary report: N

OPTICROSS 6 HD

MDR report key: 20774912 · Received November 25, 2024

Report

Report Number
2124215-2024-73521
Event Type
Malfunction
Date Received
November 25, 2024
Date of Event
September 1, 2024
Report Date
December 9, 2024
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
OBJ
UDI-DI
08714729960775
PMA / PMN Number
K173820
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SD, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

G4 PREMARKET / 510(K) # - K173820, K213593

Additional Manufacturer Narrative · 0

B3 DATE OF EVENT WAS ESTIMATED BASED ON THE AWARE DATE AS THE EVENT DATE WAS NOT REPORTED. G4 PREMARKET / 510(K) # - K173820, K213593. THE DEVICE WAS RETURNED FOR ANALYSIS. VISUAL AND MICROSCOPIC INSPECTION REVEALED THE IMAGING WINDOW WAS TWISTED. VISUAL INSPECTION SHOWED NO DAMAGES OR FAILURES WITH THE CATHETER CODE PCBA BOARD ASSEMBLY. MICROSCOPIC INSPECTION SHOWED THE GUIDEWIRE EXIT PORT AND THE DISTAL SECTION OF THE TIP WERE IN GOOD CONDITION. IMPEDANCE TESTING SHOWED AN ELECTRICAL OPEN AT THE PROXIMAL END OF THE CATHETER BETWEEN 100-110 CM FROM THE DISTAL HOUSING.

Description of Event or Problem · 0

IT WAS REPORTED THAT A CATHETER ISSUE OCCURRED. THE OPTICROSS 6 HD WAS ADVANCED FOR ULTRASOUND EXAMINATION OF THE TARGET LESION. GOOD IMAGING WAS NOT ABLE TO BE OBTAINED, AND THE MATERIAL BECAME TWISTED OUTSIDE THE PATIENT.

Description of Event or Problem · 0

IT WAS REPORTED THAT A CATHETER ISSUE OCCURRED. THE OPTICROSS 6 HD WAS ADVANCED FOR ULTRASOUND EXAMINATION OF THE TARGET LESION. GOOD IMAGING WAS NOT ABLE TO BE OBTAINED, AND THE MATERIAL BECAME TWISTED OUTSIDE THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2235681 OPTICROSS 6 HD CATHETER, ULTRASOUND, INTRAVASCULAR OBJ BOSTON SCIENTIFIC CORPORATION H74939354080 0034373690 08714729960775

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown