FDA Adverse Event Malfunction Summary report: N

GREENLIGHT MOXY FIBER OPTIC

MDR report key: 3902274 · Received June 30, 2014

Report

Report Number
2937094-2014-00560
Event Type
Malfunction
Date Received
June 30, 2014
Date of Event
June 6, 2014
Report Date
June 9, 2014
Manufacturer
AMERICAN MEDICAL SYSTEMS, INC. (SAN JOSE)
Product Code
GEX
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PRODUCT EVALUATION: FAILURE ANALYSIS FOR FIBER (B)(4): THE FIBER SHOWS A CIRCUMFERENTIAL FRACTURE DISTAL TO FIBER/CAP FUSION ZONE AT THE BEVEL EDGE; THE FIBER PROXIMAL TO FRACTURE CAN ROTATE INDEPENDENTLY OF METAL CAP; THE GLASS CAP EXHIBITS SEVERE DEVITRIFICATION AT OUTPUT WINDOW; THE METAL CAP IS MELTED AT THE OUTPUT WINDOW; THE OUTER FLOW TUBING EXHIBITS SCRATCH MARKS AT THE OPEN END. BASED ON THE ANALYSIS ABOVE, THE POTENTIAL FOR FORWARD FIRING MAY EXIST. PROBABLE ROOT CAUSE: BASED ON THE PRODUCT ANALYSIS RESULTS, THE PROBABLE ROOT CAUSE OF THE FAILURE IS: HEAT ACCUMULATION. CAP WEAR WAS ACCELERATED DUE TO ANATOMICAL/PROCEDURAL FACTORS (TISSUE CONTACT AND TECHNIQUE) ENCOUNTERED DURING THE PROCEDURE WHICH WOULD LIMIT THE PERFORMANCE OF THE FIBER. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE FIBER WOULD NOT COAGULATE AND THE TIP WAS LOOSE. THE PROCEDURE WAS COMPLETED USING A SECOND FIBER. THERE WAS "NO PATIENT INJURY" REPORTED. GLAND VOLUME 40 ML. JOULES USED 33,722. TIME EXPENDED 16:38 MINUTES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
379424 GREENLIGHT MOXY FIBER OPTIC POWERED LASER SURGICAL INSTRUMENT GEX AMERICAN MEDICAL SYSTEMS, INC. (SAN JOSE) 0010-2400 344A

Patients

Seq Age Sex Outcome Treatment
1