FDA Adverse Event Malfunction Summary report: N

LEVEEN¿ STANDARD

MDR report key: 2919206 · Received January 16, 2013

Report

Report Number
3005099803-2013-00197
Event Type
Malfunction
Date Received
January 16, 2013
Date of Event
December 28, 2012
Report Date
December 31, 2012
Manufacturer
BOSTON SCIENTIFIC - SPENCER
Product Code
GEI
PMA / PMN Number
K982556
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
EG
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

REPORTED EVENT: FAILURE TO ACHIEVE ROLL-OFF. THE COMPLAINT DEVICE HAS BEEN RECEIVED BY THE MANUFACTURER; HOWEVER, A FAILURE ANALYSIS HAS NOT YET BEEN COMPLETED. UPON RECEIPT OF THE FAILURE ANALYSIS, IF THERE IS ANY FURTHER RELEVANT INFORMATION FROM THAT REVIEW, A SUPPLEMENTAL MEDWATCH WILL BE FILED.

Additional Manufacturer Narrative · 1

DEVICE EVALUATION: VISUAL EVALUATION OF THE RETURNED DEVICE FOUND NO ISSUES, AND THE TINES EXTENDED AND RETRACTED AS INTENDED DURING FUNCTIONAL TESTING. THE TINES WERE OBSERVED TO BE EVENLY SPACED AND PROPERLY FORMED. ELECTRICAL TESTING CONFIRMED THE DEVICE WAS ABLE TO CONDUCT CURRENT PROPERLY. THE COMPLAINT COULD NOT BE CONFIRMED; THE RETURNED DEVICE COULD NOT BE FUNCTIONALLY EVALUATED WITH RESPECT TO INSUFFICIENT ROLL-OFF WHILE IN USE. PER THE LEVEEN NEEDLE ELECTRODE FAMILY DIRECTIONS FOR USE, (DFU), "OCCASIONALLY, TISSUE IMMEDIATELY ADJACENT TO MULTIPLE, LARGE BLOOD VESSELS MAY NOT SHOW A SIGNIFICANT RISE IN IMPEDANCE, AND ALSO MAY SHOW LITTLE, IF ANY, CHANGE IN TISSUE WITH APPROPRIATE IMAGE MONITORING DUE TO THE OVERWHELMING HEAT-SINK EFFECT OF LOCALIZED BLOOD FLOW. IF THERE HAS BEEN LITTLE TO NO RISE IN IMPEDANCE AFTER 15 MINUTES HAVE ELAPSED, DETERMINE WITH THE APPROPRIATE IMAGING METHOD THE LOCATION OF THE TINES OF THE ELECTRODE IN RELATION TO A REGION OF HIGH VASCULARITY (E.G., BLOOD VESSELS). IF APPROPRIATE, REPOSITION THE ELECTRODE APPROXIMATELY 0.5 CM (5 MM) PROXIMAL OR DISTAL TO THE REGION OF HIGH VASCULARITY PRIOR TO RESUMING THE APPLICATION OF RADIOFREQUENCY (RF) ENERGY INTO THE TISSUE." BASED ON THIS INFORMATION, THIS EVENT IS CONSIDERED AN ANTICIPATED PROCEDURAL COMPLICATION. A REVIEW OF THE DEVICE HISTORY RECORD (DHR) WAS PERFORMED; NO ANOMALIES WERE NOTED. A SEARCH OF THE COMPLAINT DATABASE REVEALED THAT NO OTHER COMPLAINTS EXIST FOR THE SPECIFIED LOT.

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A LEVEEN STANDARD ELECTRODE WAS USED DURING RADIOFREQUENCY ABLATION (RFA) OF A FOCAL HEPATIC LESION PERFORMED ON (B)(6) 2012. ACCORDING TO THE COMPLAINANT, NO CHANGE IN IMPEDANCE WAS NOTED DURING THE FIRST 15-MINUTE ABLATION INTERVAL. THE GENERATOR WAS RESTARTED AND ANOTHER 15-MINUTE INTERVAL WAS PERFORMED WITH THE SAME POWER SETTING; HOWEVER, ONCE AGAIN NO CHANGE IN IMPEDANCE WAS NOTED. THE PROCEDURE WAS THEN COMPLETED WITH ANOTHER LEVEEN STANDARD ELECTRODE AND ROLL-OFF WAS ACHIEVED. THERE WERE NO PATIENT COMPLICATIONS REPORTED AS A RESULT OF THIS EVENT. THE PATIENT WAS REPORTED TO BE IN STABLE CONDITION FOLLOWING THE PROCEDURE.

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A LEVEEN STANDARD ELECTRODE WAS USED DURING RADIOFREQUENCY ABLATION (RFA) OF A FOCAL HEPATIC LESION PERFORMED ON (B)(6) 2012. ACCORDING TO THE COMPLAINANT, NO CHANGE IN IMPEDANCE WAS NOTED DURING THE FIRST 15-MINUTE ABLATION INTERVAL. THE GENERATOR WAS RESTARTED AND ANOTHER 15-MINUTE INTERVAL WAS PERFORMED WITH THE SAME POWER SETTING; HOWEVER, ONCE AGAIN NO CHANGE IN IMPEDANCE WAS NOTED. THE PROCEDURE WAS THEN COMPLETED WITH ANOTHER LEVEEN STANDARD ELECTRODE AND ROLL-OFF WAS ACHIEVED. THERE WERE NO PATIENT COMPLICATIONS REPORTED AS A RESULT OF THIS EVENT. THE PATIENT WAS REPORTED TO BE IN STABLE CONDITION FOLLOWING THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
25093 LEVEEN¿ STANDARD ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES GEI BOSTON SCIENTIFIC - SPENCER M001262130 15070407

Patients

Seq Age Sex Outcome Treatment
1 61 YR