BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    GREENLIGHT MOXY FIBER OPTIC

    MDR report key: 2871745 · Received December 11, 2012

    Report

    Report Number
    2937094-2012-01250
    Event Type
    Malfunction
    Date Received
    December 11, 2012
    Date of Event
    November 15, 2012
    Report Date
    November 15, 2012
    Manufacturer
    AMERICAN MEDICAL SYSTEMS
    Product Code
    GEX
    PMA / PMN Number
    K100746
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FR
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THERE WAS A MID-FIBER BREAK APPROX 20 CM FROM THE BEGINNING OF THE FIBER; THE AIM BEAM COULD BE SEEN THROUGH THE FIBER AREA BROKEN. THE PROCEDURE WAS COMPLETED WITH A SECOND FIBER. NO REPORT OF INJURY TO THE PT AND/OR USER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 GREENLIGHT MOXY FIBER OPTIC POWERED LASER SURGICAL INSTRUMENT GEX AMERICAN MEDICAL SYSTEMS 0010-2400 232A

    Patients

    Seq Age Sex Outcome Treatment
    1 ACCESSORIES| GREENLIGHT XPS LASER SYSTEM