FDA Adverse Event Malfunction Summary report: N

GREENLIGHT HPS BPH FIBER OPTIC

MDR report key: 3983584 · Received August 6, 2014

Report

Report Number
2937094-2014-00689
Event Type
Malfunction
Date Received
August 6, 2014
Date of Event
June 13, 2014
Report Date
June 24, 2014
Manufacturer
AMERICAN MEDICAL SYSTEMS, INC. (SAN JOSE)
Product Code
GEX
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE FIBER CAP REMAINS ATTACHED AND EXHIBITS A DRILLED THROUGH CONDITION; THERE IS SOME WHITE UNKNOWN SUBSTANCE NOTED INSIDE THE FIBER CAP TIP; THE BEVEL SECTION IS MELTED; THE GLASS CAP EXHIBITS MILD DETRITUS ADHESION. BASED ON THE ANALYSIS, THE POTENTIAL FOR FORWARD FIRING MAY EXIST. PROBABLE ROOT CAUSE: BASED ON THE PRODUCT ANALYSIS RESULTS, THE PRODUCT COMPLAINT OF "BLOWN FIBER TIP" COLD NOT BE CONFIRMED; A CAP MELTED WAS OBSERVED; 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.

Description of Event or Problem · 1

IT WAS REPORTED THAT TIP DAMAGE OCCURRED WHILE USING FOUR SURGICAL FIBERS DURING A PROSTATE PROCEDURE (AT 1,672 J, 2,447 J, 1,041 J, AND 4,157 JOULES OF USE RESPECTIVELY). THE PROCEDURE WAS COMPLETED USING A FIFTH SURGICAL FIBER. THERE WAS NO PATIENT INJURY REPORTED. THIS REPORT IS FOR THE THIRD SURGICAL FIBER USED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
460818 GREENLIGHT HPS BPH FIBER OPTIC POWERED LASER SURGICAL INSTRUMENT GEX AMERICAN MEDICAL SYSTEMS, INC. (SAN JOSE) 0010-2090 347H

Patients

Seq Age Sex Outcome Treatment
1