FDA Adverse Event Malfunction Summary report: N

GREENLIGHT MOXY FIBER OPTIC

MDR report key: 3883049 · Received June 19, 2014

Report

Report Number
2937094-2014-00522
Event Type
Malfunction
Date Received
June 19, 2014
Date of Event
June 11, 2014
Report Date
June 12, 2014
Manufacturer
AMERICAN MEDICAL SYSTEMS, INC. (SAN JOSE)
Product Code
GEX
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A PROSTATE PROCEDURE THE FIRST FIBER BECAME END FIRING @ 29,028 JOULES 6:27 MINUTES. THE FIBER WAS EXCHANGED AND THE SECOND FIBER ALSO EXHIBITED END FIRING. IT WAS NOTED BY THE INITIAL REPORTER THAT THIS ISSUE(S) OCCURRED DUE TO PROSTATIC CALCIFICATIONS (STONES). THE PROCEDURE WAS COMPLETED WITH A THIRD FIBER. PATIENT OUTCOME: ¿OK¿ REPORTED. THIS REPORT IS FOR THE FIRST FIBER:

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
359995 GREENLIGHT MOXY FIBER OPTIC POWERED LASER SURGICAL INSTRUMENT GEX AMERICAN MEDICAL SYSTEMS, INC. (SAN JOSE) 0010-2400 405A

Patients

Seq Age Sex Outcome Treatment
1