FDA Adverse Event Malfunction Summary report: N

STEALTHSTATION S7 SYSTEM

MDR report key: 3180634 · Received June 20, 2013

Report

Report Number
1723170-2013-00454
Event Type
Malfunction
Date Received
June 20, 2013
Date of Event
May 2, 2013
Report Date
May 24, 2013
Manufacturer
MEDTRONIC NAVIGATION, INC.
Product Code
HAW
PMA / PMN Number
K050438
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
RISK MANAGER

Narratives

Additional Manufacturer Narrative · 1

PATIENT WEIGHT WAS NOT AVAILABLE FROM THE SITE. THIS WAS REPORTED TO THE MANUFACTURER VIA MEDWATCH# (B)(4) ON (B)(6) 2013. DATE OF THE INCIDENT LISTED ON THE MEDWATCH FORM WAS (B)(6) 2013. THESE FIELDS WERE COMPLETED ON MEDWATCH# (B)(4) ALTHOUGH THE COMPONENT REPORTED "NAVIGATION ARM" IS A REUSABLE DEVICE. A MEDTRONIC REP WENT TO THE SITE TO COLLECT THE SUSPECT COMPONENT. HOWEVER, THE SITE REP REFUSED TO RELINQUISH THE DEVICE PER INSTRUCTION FROM THE SITE'S LEGAL DEPARTMENT. IT WAS REPORTED TO THE MEDTRONIC REP THAT THE SITE HAD SENT THE DEVICE TO A 3RD PARTY VENDOR FOR REPAIR PRIOR TO THE REPORTED EVENT. NO PARTS OR FILES HAVE BEEN RECEIVED BY THE MANUFACTURER.

Description of Event or Problem · 1

A SITE REPRESENTATIVE REPORTED VIA MEDWATCH# (B)(4) THAT A PATIENT WAS SCHEDULED FOR A RIGHT FRONTAL LESION BIOPSY WITH THE USE OF A INTRAOPERATIVE NAVIGATION SYSTEM. THE NAVIGATION ARM, WHICH IS ATTACHED TO THE REFERENCE FRAME, WAS LOOSE. ONCE A FUNCTIONING ARM WAS IDENTIFIED THE CASE WAS SUCCESSFULLY COMPLETED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
281583 STEALTHSTATION S7 SYSTEM NEUROLOGICAL STEREOTAXIC INSTRUMENT HAW MEDTRONIC NAVIGATION, INC. S7

Patients

Seq Age Sex Outcome Treatment
1 56 YR