FDA Adverse Event Malfunction Summary report: N

POWERLED

MDR report key: 7694088 · Received July 17, 2018

Report

Report Number
9710055-2018-00056
Event Type
Malfunction
Date Received
July 17, 2018
Report Date
November 8, 2018
Manufacturer
MAQUET SAS
Product Code
FSY
PMA / PMN Number
K070442
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

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 INVESTIGATED BY MANUFACTURING SITE.

Additional Manufacturer Narrative · 0

MAQUET SAS BECAME AWARE OF AN INCIDENT WITH ONE OF SURGICAL LIGHTS- POWERLED DEVICE AS STATED IN THE COMPLAINT, THE HANDLE AROUND THE LIGHT WAS DISCOVERED BROKEN BY DOCTOR, WHO TRIED TO ADJUST THE LIGHT AT THE BEGINNING OF THE SURGICAL PROCEDURE. FORTUNATELY, THERE WAS NO ADVERSE OUTCOME REPORTED. THE FACILITY MAINTENANCE STAFF SUPERGLUED AND TAPED THE HANDLE BACK ON. THE ISSUE WAS RAISE TO THE COMPANY¿S REPRESENTATIVE. THE TECHNICIAN VISITED THE FACILITY AND FOUND TWO OF THE TREE BRACKETS HOLDING THE HANDLE FAULTY. HE WAS ABLE TO REPAIR THE DEVICE BY REPLACING THE HANDLE. AFTER THE REPLACEMENT, THE DEVICE WAS RETURNED TO USE. THE DEVICE HAS BEEN RECOGNIZED AS POWERLED WITH THE SERIAL NUMBER: (B)(6). DEFECTIVE PART NUMBER IS ARD568303999. DEVICE WAS MANUFACTURED IN 13TH SEPTEMBER, 2007 AND IS NOT UNDER GETINGE SERVICE AGREEMENT. DURING THE INVESTIGATION IT WAS FOUND THAT THERE IS NO APPARENT TREND WITH THE ISSUE AT HAND AND THAT THE REPORTED SCENARIO HAS NEVER LED TO SERIOUS INJURY OR WORSE. LOOKING AT THE AGE OF PRODUCT (11 YEARS) WE CAN CONCLUDE THAT THE ISSUE IS THE RESULT OF WEAR AND TEAR AND THERE COULD BE SEVERAL SHOCKS OF THE HANDLE. IN SUMMARY, THE SURGICAL LIGHT 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, THUS THE MAQUET DEVICE PLAYED A ROLE ON THE EVENT. GIVEN THE CIRCUMSTANCES AND THE FACT THAT MAQUET HAD INSTALLED APPROXIMATELY 33670 POWER LED DEVICES TO DATE AND THIS COMPLAINT IS THE 3RD ONE OF THIS NATURE, WE BELIEVE THE RELATED DEVICES ARE PERFORMING CORRECTLY IN THE MARKET AND DO NOT PROPOSE ANY FURTHER ACTION AS THIS TIME. 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. CONTACT PERSON: (B)(4).

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).

Description of Event or Problem · 0

ON (B)(6) 2018 MAQUET SAS BECAME AWARE OF AN ISSUE WITH ONE OF SURGICAL LIGHTS- POWERLED. AS STATED IN THE COMPLAINT, THE HANDLE AROUND THE LIGHT HAS BROKEN AT THE BEGINNING OF THE CASE. THERE IS NO INJURY REPORTED. MFG REFERENCE NUMBER IS 171399-2018-000378.

Description of Event or Problem · 0

MFG REFERENCE NUMBER IS (B)(4).

Description of Event or Problem · 0

MFG REFERENCE NUMBER IS (B)(4).

Additional Manufacturer Narrative · 1

THE ISSUE IS STILL BEING INVESTIGATED BY MANUFACTURING SITE. (B)(4). EXEMPTION # E2018005. (B)(4). A FOLLOW-UP MEDWATCH WILL BE SUBMITTED WHEN ADDITIONAL INFORMATION BECOMES AVAILABLE.

Additional Manufacturer Narrative · 1

(B)(4). EXEMPTION # E2018005. (B)(4). THE ISSUE IS STILL BEING INVESTIGATED BY MANUFACTURING SITE. A FOLLOW-UP MEDWATCH WILL BE SUBMITTED WHEN ADDITIONAL INFORMATION BECOMES AVAILABLE.

Description of Event or Problem · 1

MFG REFERENCE NUMBER IS (B)(4).

Description of Event or Problem · 1

MFG REFERENCE NUMBER IS (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
535307 POWERLED LIGHT, SURGICAL, CEILING MOUNTED FSY MAQUET SAS

Patients

Seq Age Sex Outcome Treatment
1