FDA Adverse Event Malfunction Summary report: N

GREENLIGHT XPS MOXY FIBER OPTIC

MDR report key: 3061587 · Received April 11, 2013

Report

Report Number
2937094-2013-00434
Event Type
Malfunction
Date Received
April 11, 2013
Date of Event
April 1, 2013
Report Date
April 2, 2013
Manufacturer
AMERICAN MEDICAL SYSTEMS
Product Code
GEX
PMA / PMN Number
K120870
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A PROSTATE PROCEDURE, FORWARD FIRING AT 50000J WAS OBSERVED. A SECOND FIBER WAS USED TO COMPLETE THE CASE. NO INJURY TO PATIENT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
154489 GREENLIGHT XPS MOXY FIBER OPTIC POWERED SURGICAL LASER INSTRUMENT GEX AMERICAN MEDICAL SYSTEMS 0010-2400 304B

Patients

Seq Age Sex Outcome Treatment
1