FDA Adverse Event Malfunction Summary report: N

HF-CABLE, MONOPOLAR, 4 M, UES-30/-40,

MDR report key: 5802942 · Received July 19, 2016

Report

Report Number
2951238-2016-00600
Event Type
Malfunction
Date Received
July 19, 2016
Date of Event
June 20, 2016
Report Date
November 22, 2016
Manufacturer
OLYMPUS WINTER & IBE GMBH
Product Code
DSA
PMA / PMN Number
PK944201
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS NOT RETURNED TO OLYMPUS FOR EVALUATION. THE CAUSE OF THE REPORTED EVENT COULD NOT BE DETERMINED; HOWEVER, USER HANDLING COULD NOT BE RULED OUT AS A CONTRIBUTING FACTOR. THE INSTRUCTION MANUAL CONTAINS SEVERAL WARNING STATEMENTS IN AN EFFORT TO PREVENT DAMAGE TO THE CABLE. ¿VISUALLY INSPECT THE CABLE AND THE PLUGS FOR IRREGULARITIES ON THE SURFACE. DO NOT USE A CABLE WITH BRITTLE OR DEFECTIVE INSULATION. REPLACE THE CABLE. IN ORDER TO PLUG OR UNPLUG THE CABLE ALWAYS PULL AT THE PLUG. NEVER PULL AT THE CABLE.¿

Additional Manufacturer Narrative · 1

THE HIGH FREQUENCY (HF) CABLE WAS RETURNED TO OLYMPUS FOR EVALUATION. THE EVALUATION CONFIRMED THAT THE HF CABLE BROKEN INTO TWO PIECES AND FOUND DETACHED. THE HF CABLE COULD NOT BE TESTED DUE TO ITS RECEIVED CONDITION; HOWEVER, A MICROSCOPIC INSPECTION WAS PERFORMED ON THE RETURNED CABLE AND FOUND CHARRED STAINS INSIDE THE INTERNAL WIRES OF THE DISTAL END PLUG, WHICH IS THE PART THAT WAS CONNECTED TO THE WORKING ELEMENT. THERE WERE WHITE RESIDUES NOTED ON THE CABLE INSULATION HOUSING FROM THE PROXIMAL END PLUG. BASED ON THE INVESTIGATION FINDINGS, IT WAS DETERMINED THAT THE MOST LIKELY CAUSE OF THE REPORTED EVENT IS A SHORT ON THE INTERNAL WIRES OF THE CABLE.

Description of Event or Problem · 1

OLYMPUS WAS INFORMED THAT DURING A TRANSURETHRAL RESECTION OF THE PROSTATE (TURP) PROCEDURE, THE HIGH FREQUENCY (HF) CABLE SPARKED AND SMOKED. THERE WAS NO INJURY TO THE USER OR PATIENT. NO EMERGENCY FIRE EVACUATION TOOK PLACE. THE PROCEDURE WAS COMPLETED USING A DIFFERENT HF CABLE. THIS IS REPORT 2 OF 4.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
456972 HF-CABLE, MONOPOLAR, 4 M, UES-30/-40, HF CABLE DSA OLYMPUS WINTER & IBE GMBH A0393 342998

Patients

Seq Age Sex Outcome Treatment
1