FDA Adverse Event Malfunction Summary report: N

NITINOL TC ELECTRODE

MDR report key: 6921391 · Received October 6, 2017

Report

Report Number
3006630150-2017-03818
Event Type
Malfunction
Date Received
October 6, 2017
Date of Event
September 14, 2017
Report Date
September 14, 2017
Manufacturer
COSMAN MEDICAL
Product Code
GXI
UDI-DI
00813250013054
PMA / PMN Number
K050084
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE TWO RETURNED ELECTRODES WITH LOT NUMBER 071916 WERE ANALYZED AND VISUAL INSPECTION FOUND THAT THE EPOXY HAS CHIP OUT AND DISCOLORATION. THE COLOR OF NEWLY CURED EPOXY IS AMBER, LIGHT BROWN. IF THE EPOXY IS SUBJECTED TO TOO MANY AUTOCLAVE CYCLES IT BECOMES BRITTLE AND DISCOLORED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
704214 NITINOL TC ELECTRODE ELECTRODES GXI COSMAN MEDICAL TCN-10 071916 00813250013054

Patients

Seq Age Sex Outcome Treatment
1