BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    GREENLIGHT HPS FIBER OPTIC

    MDR report key: 3113120 · Received May 9, 2013

    Report

    Report Number
    2937094-2013-00549
    Event Type
    Malfunction
    Date Received
    May 9, 2013
    Date of Event
    March 22, 2013
    Report Date
    April 23, 2013
    Manufacturer
    AMERICAN MEDICAL SYSTEMS
    Product Code
    GEX
    PMA / PMN Number
    K062719
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CT, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    REFERENCE MFR. REPORT # 2937094-2013-00435. FIBER ANALYSIS: THE FIBER CAP WAS FOUND TO BE ATTACHED AND INTACT, HOWEVER DRILLED THROUGH AND EXHIBITING DETRITUS. THE FIBER CAP CONDITION WOULD PREVENT PROPER FIBER FUNCTION; LIKELY RESULTING IN A DIFFUSE BEAM AND REDUCED TISSUE VAPORIZATION EFFICIENCY. THE DRILLED THROUGH FIBER CAP CONDITION MAY ALSO RESULT IN A FORWARD FIRING CONDITION OF THE SIDE-FIRING SURGICAL FIBER. THE MOST PROBABLE ROOT CAUSE OF THE DEVICE FAILURE WAS DETERMINED TO BE HEAT ACCUMULATION/USER HANDLING DUE TO TISSUE CONTACT AND OR TECHNIQUE AND ANATOMICAL/PROCEDURAL FACTORS ENCOUNTERED DURING THE PROCEDURE, LIMITING THE PERFORMANCE OF THE FIBER.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT DURING A PROSTATE PROCEDURE, THE FIBER BROKE OFF AT 91900J AND WAS NOT RETRIEVED. A SECOND FIBER WAS USED AND TIP WAS DAMAGED AT 70000J. THE CASE WAS COMPLETED WITH A THIRD FIBER. PATIENT OUTCOME: "OKAY." THIS REPORT IS FOR THE SECOND FIBER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    204969 GREENLIGHT HPS FIBER OPTIC POWERED SURGICAL LASER INSTRUMENT GEX AMERICAN MEDICAL SYSTEMS 0010-2090 244H

    Patients

    Seq Age Sex Outcome Treatment
    1