FDA Adverse Event Death Summary report: N

X7-2T TRANSDUCER (MTEE) COMPACT

MDR report key: 6041902 · Received October 19, 2016

Report

Report Number
3019216-2016-00040
Event Type
Death
Date Received
October 19, 2016
Report Date
October 11, 2016
Manufacturer
PHILIPS ULTRASOUND, INC
Product Code
ITX
PMA / PMN Number
K123754
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BE
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

EVALUATION OF THE TRANSDUCER WILL BE INCLUDED IN A FOLLOW UP REPORT UPON ITS RETURN AND INVESTIGATION COMPLETION.

Additional Manufacturer Narrative · 1

EVALUATION OF THE TRANSDUCER FOUND A LARGE HOLE IN THE BENDING NECK SHEATH WHICH ALLOWED FLUID AND DEBRIS INGRESS. THIS DAMAGE IS INDICATIVE OF IMPROPER HANDLING AND MAINTENANCE. A BIOLOGICAL EVALUATION OF THE TRANSDUCER FOUND NO HARMFUL BACTERIA PRESENT AT THE TIME OF TESTING.

Description of Event or Problem · 1

A CUSTOMER REPORTED CROSS CONTAMINATION OF AN X7-2T MODEL TRANSDUCER IN THE CARDIAC SURGERY UNIT CAUSED A BACTERIAL INFECTION RESULTING IN PATIENT DEATH(S). AN INITIAL VISUAL INSPECTION AND SAFETY TEST OF THE DEVICE RESULTED IN NO DETECTED PROBLEMS. THE SUSPECT TRANSDUCER HAS BEEN REMOVED FROM SERVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
690360 X7-2T TRANSDUCER (MTEE) COMPACT TRANSDUCER, ULTRASONIC, DIAGNOSTIC ITX PHILIPS ULTRASOUND, INC 989605361911 B0WTX3

Patients

Seq Age Sex Outcome Treatment
1 Death