FDA Adverse Event Malfunction Summary report: N

PD103 SEEDS LOADED IN MICK CARTRIDGES, STERILE

MDR report key: 6105873 · Received November 16, 2016

Report

Report Number
1018233-2016-01623
Event Type
Malfunction
Date Received
November 16, 2016
Report Date
January 19, 2017
Manufacturer
BARD BRACHYTHERAPY, INC. -1424526
Product Code
KXK
PMA / PMN Number
K060636
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
PHYSICIST

Narratives

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE A SUPPLEMENTAL REPORT WILL BE FILED. THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO BARD. THE DEVICE WAS NOT RETURNED.

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE A SUPPLEMENTAL REPORT WILL BE FILED. THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO BARD. THE DEVICE WAS NOT RETURNED

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE A SUPPLEMENTAL REPORT WILL BE FILED. THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO BARD. THE DEVICE WAS NOT RETURNED.

Additional Manufacturer Narrative · 1

THE DEVICE WAS NOT RETURNED FOR EVALUATION. THE DEVICE HISTORY RECORD WAS REVIEWED AND FOUND NOTHING THAT COULD HAVE CAUSED OR CONTRIBUTED TO THE REPORTED EVENT. THE INSTRUCTIONS FOR USE STATE THE FOLLOWING: "THIS IS A SINGLE USE DEVICE. DO NOT RESTERILIZE ANY PORTION OF THIS DEVICE. REUSE AND/OR REPACKAGING MAY CREATE A RISK OF PATIENT OR USER INFECTION, COMPROMISE THE STRUCTURAL INTEGRITY AND/OR ESSENTIAL MATERIAL AND DESIGN CHARACTERISTICS OF THE DEVICE, WHICH MAY LEAD TO DEVICE FAILURE AND/OR LEAD TO INJURY, ILLNESS, OR DEATH OF THE PATIENT. DO NOT STORE THE SEED / SOURCECAPTM ASSEMBLIES OR BIOSPACER¿ SEEDING SPACER AT TEMPERATURES ABOVE 40C." (B)(4). THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO BARD. THE DEVICE WAS NOT RETURNED.

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE A SUPPLEMENTAL REPORT WILL BE FILED. THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO BARD. THE DEVICE WAS NOT RETURNED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE SEEDS WERE FUSED TOGETHER. THE COMPLAINANT STATED THAT A CARTRIDGE WAS DROPPED DURING THE PROCEDURE, AND WAS LATER STERILIZED AT THE FACILITY. FOLLOWING THE RE-STERILIZATION, THE SEEDS WERE FUSED, AND AN ATTEMPT TO UN-FUSE AND USE THE SEEDS WAS UNSUCCESSFUL. AS A RESULT, A TOTAL OF 65 OF 80 PLANNED SEEDS WERE IMPLANTED. DUE TO THE MALFUNCTION, THE NEEDLES WERE NOT USED FOR IMPLANTATION. IT WAS ALSO REPORTED THAT THE DECISION WAS MADE TO ADDRESS DOSE VARIANCE USING AN ALREADY PLANNED EXTERNAL BEAM TREATMENT THAT WAS SCHEDULED FOR APPROXIMATELY FOUR WEEKS LATER.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE SEEDS WERE FUSED TOGETHER. THE COMPLAINANT STATED THAT A CARTRIDGE WAS DROPPED DURING THE PROCEDURE AND WAS LATER STERILIZED AT THE FACILITY. FOLLOWING THE RE-STERILIZATION, THE SEEDS WERE FUSED, AND AN ATTEMPT TO UN-FUSE AND USE THE SEEDS WERE UNSUCCESSFUL. AS A RESULT, A TOTAL OF 65 OF 80 PLANNED SEEDS WERE IMPLANTED. DUE TO THE MALFUNCTION, THE NEEDLES WERE NOT USED FOR IMPLANTATION. THE DECISION WAS THEN MADE TO ADDRESS DOSE VARIANCE USING ALREADY PLANNED EXTERNAL BEAM TREATMENT APPROXIMATELY FOUR WEEKS LATER.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE SEEDS WERE FUSED TOGETHER. THE COMPLAINANT STATED THAT A CARTRIDGE WAS DROPPED DURING THE PROCEDURE, AND WAS LATER STERILIZED AT THE FACILITY. FOLLOWING THE RE-STERILIZATION, THE SEEDS WERE FUSED, AND AN ATTEMPT TO UN-FUSE AND USE THE SEEDS WAS UNSUCCESSFUL. AS A RESULT, A TOTAL OF 65 OF 80 PLANNED SEEDS WERE IMPLANTED. DUE TO THE MALFUNCTION, THE NEEDLES WERE NOT USED FOR IMPLANTATION. IT WAS ALSO REPORTED THAT THE DECISION WAS MADE TO ADDRESS DOSE VARIANCE USING AN ALREADY PLANNED EXTERNAL BEAM TREATMENT THAT WAS SCHEDULED FOR APPROXIMATELY FOUR WEEKS LATER.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE SEEDS WERE FUSED TOGETHER. THE COMPLAINANT STATED THAT A CARTRIDGE WAS DROPPED DURING THE PROCEDURE, AND WAS LATER STERILIZED AT THE FACILITY. FOLLOWING THE RE-STERILIZATION, THE SEEDS WERE FUSED, AND AN ATTEMPT TO UN-FUSE AND USE THE SEEDS WAS UNSUCCESSFUL. A TOTAL OF 65 OF 80 PLANNED SEEDS WERE IMPLANTED. DUE TO THE MALFUNCTION, THE NEEDLES WERE NOT USED FOR IMPLANTATION. IT WAS ALSO REPORTED THAT THE DECISION WAS MADE TO ADDRESS DOSE VARIANCE USING AN ALREADY PLANNED EXTERNAL BEAM TREATMENT THAT WAS SCHEDULED FOR APPROXIMATELY FOUR WEEKS LATER.

Description of Event or Problem · 1

IT WAS REPORTED THAT A CARTRIDGE WAS DROPPED DURING THE PROCEDURE AND WAS LATER STERILIZED AT THE FACILITY. FOLLOWING THE RE-STERILIZATION, THE SEEDS WERE FUSED, AND AN ATTEMPT TO UN-FUSE AND USE THE SEEDS WERE UNSUCCESSFUL. AS A RESULT, A TOTAL OF 65 OF 80 PLANNED SEEDS WERE IMPLANTED. DUE TO THE MALFUNCTION, THE NEEDLES WERE NOT USED FOR IMPLANTATION. THE DECISION WAS THEN MADE TO ADDRESS DOSE VARIANCE USING ALREADY PLANNED EXTERNAL BEAM TREATMENT ABOUT FOUR WEEKS LATER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
758186 PD103 SEEDS LOADED IN MICK CARTRIDGES, STERILE SEEDS KXK BARD BRACHYTHERAPY, INC. -1424526 BBAQ0133

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention