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 |