FDA Adverse Event Malfunction Summary report: N

O-ARM 1000 IMAGING SYSTEM

MDR report key: 6091109 · Received November 9, 2016

Report

Report Number
1723170-2016-04848
Event Type
Malfunction
Date Received
November 9, 2016
Date of Event
April 22, 2015
Report Date
November 9, 2016
Manufacturer
MEDTRONIC NAVIGATION, INC. (LITTLETON)
Product Code
OXO
PMA / PMN Number
K050996
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

NO PATIENT INFORMATION PROVIDED AS NO PATIENT WAS INVOLVED IN THIS CONCERN. A SITE REPRESENTATIVE REPORTED THAT THE IMAGING SYSTEM'S FUSES WERE BLOWN. THERE WAS NO PATIENT PRESENT WHEN THIS ISSUE WAS IDENTIFIED. THE FIELD ENGINEER VISITED THE SITE AFTER THE SITE HAD ALREADY REPLACED THE BLOWN FUSES. SYSTEM WAS TESTED AND ISSUE WAS RESOLVED. THE BLOWN FUSES WERE NOT RETURNED TO MANUFACTURER FOR ANALYSIS, THEREFORE, NO FINDINGS WILL BE POSSIBLE. 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.

Description of Event or Problem · 1

A SITE REPRESENTATIVE REPORTED THAT THE IMAGING SYSTEM'S FUSES WERE BLOWN. THERE WAS NO PATIENT PRESENT WHEN THIS ISSUE WAS IDENTIFIED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
740177 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