FDA Adverse Event Malfunction Summary report: N

DEVICE 8252200 NIM-RESPONSE 2.0 INTERFAC

MDR report key: 3000022 · Received March 8, 2013

Report

Report Number
1045254-2013-00235
Event Type
Malfunction
Date Received
March 8, 2013
Report Date
April 12, 2012
Manufacturer
MEDTRONIC XOMED, INC.
Product Code
ETN
PMA / PMN Number
K024316
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
ME, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

TESTING/REPAIR FOUND A DAMAGED CLIP ON THE UNIT. THE NIM SYSTEM IS INTENDED TO MONITOR SENSORY AND MOTOR PATHWAYS. IF THE SYSTEM FAILS TO PERFORM AS INTENDED (ESPECIALLY TO EFFECT OR DETECT ELECTROMYOGRAPHIC (EMG) ACTIVITY), IT PRESENTS THE POTENTIAL FOR TEMPORARY OR PERMANENT DAMAGE TO THE NERVE THAT IS PRESENT. WHEN INFORMATION SUGGESTS THAT THE NIM EQUIPMENT HAD THE POTENTIAL TO NOT STIMULATE TO AFFECT ELECTROMYOGRAPHY (EMG), OR TO DETECT EMG, IT IS ASSUMED THAT THE FAILURE WAS DEVICE-RELATED AND MAY HAVE GONE UNDETECTED. IN THIS CASE, THERE IS NO INFORMATION TO SUGGEST AN EVENT COULD NOT BE INTERPRETED FALSELY. THEREFORE, WITHOUT INFORMATION TO REASONABLY SUGGEST SERIOUS INJURY, OR THAT MEDICAL INTERVENTION WAS REQUIRED TO PRECLUDE SERIOUS INJURY, WE ARE FILING THIS REPORT AS A PRODUCT PROBLEM. THE PT INTERFACE AND CABLE PROVIDE THE MEANS FOR CARRYING ELECTROMYOGRAPHIC ACTIVITY FROM THE PT'S INNERVATED MUSCLES TO THE CONSOLE, AN INTERFACE FOR CARRYING STIMULATION SIGNALS FROM THE CONSOLE TO THE STIMULATING PROBES/ELECTRODES, AND AN INTERFACE TO THE CONSOLE FROM THE INCREMENTING PROBE. THIS PRODUCT WAS BEING USED FOR TREATMENT, NOT DIAGNOSIS.

Description of Event or Problem · 1

THE MFR HAS REFINED CRITERIA FOR MAKING MDR DECISIONS. UPON A RETROSPECTIVE REVIEW, THE FOLLOWING EVENT IS NOW BELIEVED TO BE REPORTABLE. A CUSTOMER RETURNED A NIM-PATIENT INTERFACE STATING, "NOT WORKING/INTERMITTENT." THERE WAS NO SUGGESTION OF PT INJURY OR INVOLVEMENT. TESTING/REPAIR COULD NOT CONFIRM THE REPORTED EVENT; HOWEVER, THEY DID FIND A DAMAGED CLIP ON THE UNIT. A SHORT CIRCUIT IN THE PT INTERFACE, WHICH CAN GO UNDETECTED, HAS BEEN KNOWN TO AFFECT THE DELIVERY OF STIMULUS CURRENT AND HAS THE POTENTIAL TO CAUSE OR CONTRIBUTE TO PT INJURY (LOSS OF STIMULATION DURING USE LEADING TO A FALSE NEGATIVE). A SUDDEN FAILURE IS NOT CONSISTENTLY ACCOMPANIED BY WARNING/ERROR MESSAGES DURING A PROCEDURE. AT THIS TIME WE ARE UNABLE TO CONFIRM WHETHER THE CUSTOMER RECEIVED ANY ERROR MESSAGES OR ALERTS OF THE FAULT. THIS REPORTED EVENT HAS NO REFERENCE TO AN ALARM OR WARNING; THEREFORE, IT MUST BE ASSUMED THAT AN ALARM OR WARNING WENT UNDETECTED OR DID NOT OCCUR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
100360 DEVICE 8252200 NIM-RESPONSE 2.0 INTERFAC ETN - STIMULATOR, NERVE ETN MEDTRONIC XOMED, INC. 8252200 37560700

Patients

Seq Age Sex Outcome Treatment
1