FDA Adverse Event Injury Summary report: N

4 LESION NT2000¿ PAIN MANAGEMENT RF GENERATOR

MDR report key: 7143207 · Received December 22, 2017

Report

Report Number
3002953813-2017-00060
Event Type
Injury
Date Received
December 22, 2017
Date of Event
November 29, 2017
Report Date
February 9, 2018
Manufacturer
NEUROTHERM, INC
Product Code
GXD
PMA / PMN Number
K111576
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

BASED ON THE INFORMATION PROVIDED TO ABBOTT AND THE INVESTIGATION PERFORMED, THE FIELD REPORTED EVENT OF FAILURE TO START UP WAS CONFIRMED AS THE GENERATOR WOULD NOT BOOT AND DISPLAYED A WHITE SCREEN DURING THE EVALUATION. THE GENERATOR WAS CONNECTED TO AN EXTERNAL MONITOR AND A CHECKSUM ERROR APPEARED. THE REPORTED FAILURE TO START UP WAS CONFIRMED. THE ROOT CAUSE WAS ISOLATED TO A DEPLETED CMOS BATTERY. THE DEVICE HISTORY RECORD WAS REVIEWED TO ENSURE THAT EACH MANUFACTURING AND INSPECTION OPERATION WAS PERFORMED.

Description of Event or Problem · 1

DURING AN ABLATION PROCEDURE, THE GENERATOR BOOTED TO A WHITE SCREEN AND WOULD NOT BOOT UP. MULTIPLE REBOOTS WERE PERFORMED WITH NO RESOLUTION. THE PROCEDURE WAS CANCELLED. THERE WERE NO KNOWN PATIENT CONSEQUENCES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
922612 4 LESION NT2000¿ PAIN MANAGEMENT RF GENERATOR GENERATOR, LESION, RADIOFREQUENCY GXD NEUROTHERM, INC RFG-NT-2000

Patients

Seq Age Sex Outcome Treatment
1 Other