O-ARM 1000 IMAGING SYSTEM
Report
- Report Number
- 1723170-2016-04811
- Event Type
- Malfunction
- Date Received
- November 7, 2016
- Date of Event
- February 27, 2015
- Report Date
- November 7, 2016
- Manufacturer
- MEDTRONIC NAVIGATION, INC. (LITTLETON)
- Product Code
- OXO
- PMA / PMN Number
- K050996
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IN, US
- Reporter Occupation
- BIOMEDICAL ENGINEER
Narratives
NO PATIENT INFORMATION PROVIDED AS NO PATIENT WAS INVOLVED IN THIS CONCERN. A SITE REPRESENTATIVE REPORTED THAT WHEN THEY BOOTED UP THEIR IMAGE ACQUISITION SYSTEM (IAS), THEY SAW THE MESSAGE "INITIALIZING PLEASE WAIT" ON THE PENDANT. SPECIFICALLY, THE X-RAY GENERATOR IS THE COMPONENT THAT WON'T DID NOT BECOME READY. SEVERAL SYSTEM REBOOTS HAVE NOT RESOLVED THE ISSUE. THERE WAS NO PATIENT PRESENT WHEN THIS ISSUE WAS IDENTIFIED. ONSITE INVESTIGATION SUSPECTED THAT THE COMMAND PROCESSOR (CP2) WAS THE CAUSE OF THE REPORTED EVENT AS THE FIELD ENGINEER WAS NOT ABLE TO ESTABLISH CONNECTION TO IT. REPLACEMENT OF THE CP2 RESOLVED THE ISSUE. NO FURTHER ISSUES WERE REPORTED. ANALYSIS OF THE RETURNED COMMAND PROCESSOR (CP2) COULD NOT CONFIRM THE REPORTED FAILURE AS IT PASSED ALL TESTS WITHOUT PROBLEMS. A FULL IMAGING SYSTEM CHECK-OUT WAS COMPLETED AND ALL TESTS PASSED. FULL SYSTEM FUNCTIONALITY WAS CONFIRMED AND THE SYSTEM WAS RETURNED TO SERVICE. THIS EVENT WAS IDENTIFIED DURING A RETROSPECTIVE REVIEW AS DISCUSSED WITH THE FDA (B)(4) OFFICE ON (B)(6) 2016 VIA MEDTRONIC NAVIGATION, INC. RESPONSE TO (B)(6) 2016 (B)(4). THIS REVIEW WAS PERFORMED AS A RESULT OF RECENT CHANGES/IMPROVEMENTS TO THE MEDTRONIC NAVIGATION, INC. MEDICAL DEVICE REPORT (MDR) REVIEW PROCESS AND IS FOR NON-ADVERSE EVENT REPORTABLE MALFUNCTIONS WITHIN THE LAST TWO YEARS WHERE THE REPORTED MALFUNCTION WAS NOT PREVIOUSLY ASSOCIATED WITH SERIOUS INJURIES. SIMILAR MALFUNCTIONS THAT HAD RESULTED IN SIGNIFICANT DELAYS OF SURGERY OR REQUIRED ADDITIONAL INTERVENTION HAD BEEN REPORTED AS MDR SERIOUS INJURIES. BASED ON THIS (B)(4) OBSERVATION, THE REPORTING DETERMINATION HAS BEEN REVISED TO CONSIDER THESE MALFUNCTION EVENTS REPORTABLE. THIS PROCESS CHANGE RESULTED IN AN OVERALL INCREASE IN THE NUMBER OF MDRS FILED BY MEDTRONIC NAVIGATION, INC., SINCE (B)(6) 2016. IT SHOULD BE NOTED THAT THIS INCREASE IS NOT THE RESULT OF THE DISCOVERY OF NEW PRODUCT PROBLEMS, BUT RATHER THE RESULT OF A BROADER INTERPRETATION AND APPLICATION OF THE REGULATIONS WITHIN OUR PROCESSES.
A SITE REPRESENTATIVE REPORTED THAT WHEN THEY BOOTED UP THEIR IMAGE ACQUISITION SYSTEM (IAS), THEY SAW THE MESSAGE "INITIALIZING PLEASE WAIT" ON THE PENDANT. SPECIFICALLY, THE X-RAY GENERATOR IS THE COMPONENT THAT WON'T DID NOT BECOME READY. SEVERAL SYSTEM REBOOTS HAVE NOT RESOLVED THE ISSUE. THERE WAS NO PATIENT PRESENT WHEN THIS ISSUE WAS IDENTIFIED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 734155 | O-ARM 1000 IMAGING SYSTEM | IMAGE-INTENSIFIED FLUOROSCOPIC X-RAY SYSTEM, MOBILE | OXO | MEDTRONIC NAVIGATION, INC. (LITTLETON) | BI-700-00027-120 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |