FDA Adverse Event Malfunction Summary report: N

SUPERDIMENSION INREACH SYSTEM

MDR report key: 3042562 · Received April 4, 2013

Report

Report Number
3004962788-2013-00009
Event Type
Malfunction
Date Received
April 4, 2013
Date of Event
March 8, 2013
Report Date
April 4, 2013
Manufacturer
SUPERDIMENSION INC.
Product Code
JAK
PMA / PMN Number
K092365
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

SUPERDIMENSION IS THE PROCESS OF RETRIEVING PROCEDURE RECORDINGS FOR EVALUATION. SUPERDIMENSION IS FILING THIS MDR IN AN ABUNDANCE OF CAUTION DUE TO THE RISKS ASSOCIATED WITH MULTIPLE EXPOSURES TO ANESTHESIA.

Description of Event or Problem · 1

SITE REPORTED THEY WERE NOT ABLE TO GET THE SUPERDIMENSION SYSTEM TO NAVIGATE TO A TARGET DURING A CASE. THE SUPERDIMENSION PORTION OF THE CASE WAS CANCELLED AND THE PATIENT WAS UNDER GENERAL ANESTHESIA. THERE WAS NO REPORT OF PATIENT INJURY, DEATH OR OTHER SERIOUS ADVERSE EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
138525 SUPERDIMENSION INREACH SYSTEM ELECTROMAGNETIC NAVIGATION BRONCHOSCOPY JAK SUPERDIMENSION INC. AA500161-12

Patients

Seq Age Sex Outcome Treatment
1