FDA Adverse Event Malfunction Summary report: N

HANAULUX 2004

MDR report key: 7548580 · Received May 29, 2018

Report

Report Number
9710055-2018-00032
Event Type
Malfunction
Date Received
May 29, 2018
Date of Event
April 18, 2018
Report Date
October 5, 2018
Manufacturer
MAQUET SAS
Product Code
FSY
PMA / PMN Number
K895715
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

THE ISSUE IS STILL BEING INVESTIGATED BY MANUFACTURING SITE. GETINGE USA SALES, LLC (IMPORTER) IS SUBMITTING THIS REPORT ON BEHALF OF THE LEGAL MANUFACTURER OF THE DEVICE MAQUET SAS, PARC DE LIMÈRE, AVENUE DE LA POMME DE PI ORLÉANS CEDEX 2, FRANCE 45074. EXEMPTION # E2018005. GETINGE USA SALES, LLC, 45 BARBOUR POND DRIVE, WAYNE, NJ 07470. CONTACT PERSON: (B)(4).

Additional Manufacturer Narrative · 0

GETINGE USA SALES, LLC (IMPORTER) IS SUBMITTING THIS REPORT ON BEHALF OF THE LEGAL MANUFACTURER OF THE DEVICE MAQUET SAS, PARC DE LIMÈRE, AVENUE DE LA POMME DE PI ORLÉANS CEDEX 2, FRANCE 45074. EXEMPTION # E2018005. GETINGE USA SALES, LLC, 45 BARBOUR POND DRIVE, WAYNE, NJ 07470. CONTACT PERSON: (B)(4). THE ISSUE IS BEING INVESTIGATED BY MANUFACTURING SITE.

Additional Manufacturer Narrative · 0

GETINGE USA SALES, LLC (IMPORTER) IS SUBMITTING THIS REPORT ON BEHALF OF THE LEGAL MANUFACTURER OF THE DEVICE MAQUET SAS, PARC DE LIMÈRE, AVENUE DE LA POMME DE PI ORLÉANS CEDEX 2, FRANCE 45074. EXEMPTION # E2018005. GETINGE USA SALES, LLC, 45 BARBOUR POND DRIVE, WAYNE, NJ 07470. CONTACT PERSON: (B)(4). THE ISSUE IS STILL BEING INVESTIGATED BY MANUFACTURING SITE.

Additional Manufacturer Narrative · 0

MAQUET SAS BECAME AWARE OF AN INCIDENT WITH ONE OF SURGICAL LIGHTS- HANAULUX 2004 DEVICE. IT WAS STATED THAT THE SAFETY RING BROKE AND LIGHT HEAD FELL ON THE GROUND NEXT TO THE PATIENT IN THE DELIVERY ROOM. IT WAS FOUND THAT WHEN THE EVENT OCCURRED, THE SURGICAL LIGHT LIKELY DID NOT MEET ITS SPECIFICATION AND IT CONTRIBUTED TO EVENT. IN THE TIME WHEN THE EVENT OCCURRED THE DEVICE WAS BEING USED FOR THE PATIENT TREATMENT. DURING THE INVESTIGATION IT WAS FOUND THAT THERE IS NO APPARENT TREND WITH THE ISSUE AT HAND AND THAT THE REPORTED SCENARIO HAS LED ONCE TO SERIOUS INJURY OR WORSE. IT WAS FOUND THAT THE POSSIBLE ROOT CAUSE OF THIS EVENT IS DEGRADATION OF THE PLASTIC SAFETY SLEEVE, WHICH AFTER A LONG PERIOD OF USE, CAN DISTORT OR DETERIORATE THROUGH THE USE OF AGGRESSIVE CLEANING PRODUCTS OR DISINFECTANTS. PLEASE NOTE THAT THE DEVICE WAS MANUFACTURED IN 1996, IT IN USE FOR 22 YEARS UNTIL THE EVENT OCCURRED. THE MALFUNCTIONED PART ¿ A SAFETY SLEEVE - SHOULD BE CHECKED EVERY 6 MONTHS DURING RECOMMENDED MAINTENANCE AS DESCRIBED IN THE CHAPTER ¿INSPECTION BY THE OPERATOR¿ IN THE USER MANUAL FOR HLX 2000 DEVICE 56351039/E. AS PER INCIDENT SCENARIO AND THE FACT THAT THE INFORMATION ABOUT PREVENTIVE MAINTENANCE IS NOT AVAILABLE WE CAN CONCLUDE THAT A DEVICE WAS NOT WELL MAINTAINED AND THE MANUFACTURER¿S RECOMMENDATIONS WERE NOT FOLLOWED DESCRIBED ALIKE IN THE USER MANUAL AND TECHNICAL NOTICE. WE BELIEVE THE RELATED DEVICES ARE PERFORMING CORRECTLY IN THE MARKET. WE ALSO BELIEVE THAT IF THE MANUFACTURER RECOMMENDATION WOULD HAVE BEEN FOLLOWED THE INCIDENT WOULD HAVE BEEN AVOIDED. GETINGE USA SALES, LLC (IMPORTER) IS SUBMITTING THIS REPORT ON BEHALF OF THE LEGAL MANUFACTURER OF THE DEVICE MAQUET SAS, PARC DE LIMÈRE, AVENUE DE LA POMME DE PI ORLÉANS CEDEX 2, FRANCE 45074 EXEMPTION # E2018005. GETINGE USA SALES, LLC (B)(4). CONTACT PERSON: (B)(6).

Additional Manufacturer Narrative · 0

THE ISSUE IS STILL BEING INVESTIGATED BY MANUFACTURING SITE. GETINGE USA SALES, LLC (IMPORTER) IS SUBMITTING THIS REPORT ON BEHALF OF OF THE LEGAL MANUFACTURER OF THE DEVICE MAQUET SAS, PARC DE LIMÈRE, AVENUE DE LA POMME DE PI ORLÉANS CEDEX 2, FRANCE 45074. EXEMPTION # E2018005. GETINGE USA SALES, LLC, 45 BARBOUR POND DRIVE, WAYNE, NJ 07470. CONTACT PERSON: (B)(4).

Description of Event or Problem · 0

MANUFACTURER REFERENCE NUMBER (B)(4).

Description of Event or Problem · 0

ON (B)(6) 2018 MAQUET (B)(4) BECAME AWARE OF AN INCIDENT WITH ONE OF SURGICAL LIGHTS- HANAULUX 2004. AS IT WAS STATED BY CUSTOMER, THE LIGHT HEAD FELL OFF NEXT TO THE PATIENT. THERE IS NO INJURY REPORTED. (B)(4).

Description of Event or Problem · 0

MANUFACTURER REFERENCE NUMBER: (B)(4).

Description of Event or Problem · 0

MANUFACTURER REFERENCE NUMBER (B)(4).

Description of Event or Problem · 0

MANUFACTURER REFERENCE NUMBER (B)(4).

Additional Manufacturer Narrative · 1

(B)(4). EXEMPTION # E2018005. (B)(4). THE ISSUE IS STILL BEING INVESTIGATED BY THE MANUFACTURING SITE.

Description of Event or Problem · 1

MANUFACTURER REFERENCE NUMBER (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
393330 HANAULUX 2004 LIGHT, SURGICAL, CEILING MOUNTED FSY MAQUET SAS

Patients

Seq Age Sex Outcome Treatment
1