FDA Adverse Event Malfunction Summary report: N

GREENLIGHT MOXY FIBER OPTIC

MDR report key: 3962850 · Received July 29, 2014

Report

Report Number
2937094-2014-00663
Event Type
Malfunction
Date Received
July 29, 2014
Date of Event
June 10, 2014
Report Date
June 19, 2014
Manufacturer
AMERICAN MEDICAL SYSTEMS, INC. (SAN JOSE)
Product Code
GEX
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE FIBER EXHIBITED A CIRCUMFERENTIAL FRACTURE DISTAL TO FIBER/CAP FUSION ZONE AT THE BEVEL EDGE; THE FIBER PROXIMAL TO FRACTURE ROTATED INDEPENDENTLY; THE DISTAL END OF GLASS CAP AND METAL CAP WERE DETACHED AND NOT RETURNED; THE GLASS CAP EXHIBITED MILD DEVITRIFICATION AT THE OUTPUT WINDOW; THE OUTER FLOW TUBING EXHIBITED SCRATCH MARKS AT THE OPEN END LOCATION. BASED ON THE ANALYSIS, THE POTENTIAL FOR FORWARD FIRING MAY ALSO EXIST. PROBABLE ROOT CAUSE: BASED ON THE PRODUCT ANALYSIS RESULTS, THE PROBABLE ROOT CAUSE OF THE FAILURE IS: HEAT ACCUMULATION DUE TO ANATOMICAL/PROCEDURAL FACTORS (TISSUE CONTACT AND TECHNIQUE) ENCOUNTERED DURING THE PROCEDURE WHICH LIMITING THE PERFORMANCE OF THE FIBER.

Description of Event or Problem · 1

IT WAS REPORTED THAT WHILE USING THE SURGICAL FIBER DURING A PROSTATE PROCEDURE, THE AIMING BEAM STOPPED FUNCTIONING. THE PROCEDURE WAS COMPLETED USING A SECOND SURGICAL FIBER. PATIENT OUTCOME: "OK" - THERE WAS NO INJURY REPORTED. GLAND VOLUME: 50 ML, TIME EXPENDED: 15:01, JOULES USED: 81,804.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
441613 GREENLIGHT MOXY FIBER OPTIC POWERED LASER SURGICAL INSTRUMENT GEX AMERICAN MEDICAL SYSTEMS, INC. (SAN JOSE) 0010-2400 349A

Patients

Seq Age Sex Outcome Treatment
1