FDA Adverse Event Malfunction Summary report: N

POWERLED

MDR report key: 7938589 · Received October 5, 2018

Report

Report Number
9710055-2018-00093
Event Type
Malfunction
Date Received
October 5, 2018
Date of Event
August 3, 2018
Report Date
February 21, 2019
Manufacturer
MAQUET SAS
Product Code
FSY
PMA / PMN Number
K070442
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS #1 FOLLOW-UP REPORT IS BEING SENT AS THE INITIAL SUBMISSION CONTAINED AN INCORRECT DATE AWARE DATE REFERENCE IN SECTION B AND G. THE AWARE DATE IN SECTION B WAS NOTED AS (B)(6)2018 INSTEAD OF (B)(6) 2018. SECTION G -DATE RECEIVED BY MANUFACTURER WAS ALSO INCORRECTLY NOTED AS (B)(6) 2018 INSTEAD OF (B)(6)2018. THIS FOLLOW-UP REPORT SERVES TO CORRECT BOTH ERRORS. 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.

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. MAQUET SAS BECAME AWARE OF AN ISSUE WITH SURGICAL LIGHT POWERLED 300 DEVICE. AS IT WAS STATED BY THE CUSTOMER, THE CIRCLIP BROKE ON THE HANDLE. THERE WAS NO INJURY REPORTED HOWEVER WE DECIDED TO REPORT THE ISSUE BASED ON THE POTENTIAL RELATED TO FALLING PARTS BEING POTENTIAL SOURCE OF CONTAMINATION. DURING THE INVESTIGATION IT WAS FOUND THAT WE HAVE RECEIVED SIMILAR COMPLAINTS IN THE PAST, HOWEVER NONE OF THEM HAVE LED TO SERIOUS INJURY OR WORSE. IN THE LAST 5 YEARS, ALL COMPLAINTS RECEIVED ON THAT FAILURE WERE ORIGINATED FROM GERMANY. THE INVOLVED HANDLE IS USED TO MANEUVER THE SURGICAL LIGHT TO CORRECTLY SET THE LIGHT¿S ILLUMINATION OVER THE SURGICAL AREA. IT WAS ESTABLISHED THAT WHEN THE ISSUE OCCURRED, THE DEVICE DID NOT MEET ITS SPECIFICATION AND IT CONTRIBUTED TO THE COMPLAINT. IT WAS NOT ESTABLISHED IF THE DEVICE WAS OR WAS NOT BEING USED FOR PATIENT TREATMENT AT THE TIME OF ISSUE OCCURRENCE. THE FIXATION HANDLE IS A PART THAT IS EASILY REMOVABLE AND MUST BE STERILIZED IN A STERILIZER AFTER EACH SURGICAL PROCEDURE. THE LOCKING MECHANISM IS COMPOSED BY A STEEL AXIS, A SPRING AND A CIRCLIP. IT WAS REPORTED THAT A PART OF THE LOCKING MECHANISM ON THE HANDLE (CIRCLIP) WAS BROKEN. IT WAS CONFIRMED BY TESTS RESULTS THAT THE MOST LIKELY ROOT CAUSE OF THE BREAKAGE OF CIRCLIPS IS CORROSION OF A2 STEEL. THEREFORE, IT WAS DECIDED TO CHANGE THE MATERIAL TO A4 STAINLESS STEEL.

Additional Manufacturer Narrative · 0

THE ISSUE IS 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 INCIDENT WITH ONE OF SURGICAL LIGHTS- POWERLED. THE SCREW AND NUT CAME OFF OF THE HANDLE. WE DECIDED TO REPORT THE ISSUE IN ABUNDANCE OF CAUTION AS ANY PART FALLING MIGHT BE A SOURCE OF CONTAMINATION. MANUFACTURER REFERENCE NUMBER (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- POWERLED. THE SCREW AND NUT CAME OFF OF THE HANDLE. WE DECIDED TO REPORT THE ISSUE IN ABUNDANCE OF CAUTION AS ANY PART FALLING MIGHT BE A SOURCE OF CONTAMINATION. (B)(4).

Additional Manufacturer Narrative · 1

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

Additional Manufacturer Narrative · 1

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

Additional Manufacturer Narrative · 1

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

Additional Manufacturer Narrative · 1

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

Description of Event or Problem · 1

MANUFACTURER REFERENCE NUMBER (B)(4).

Description of Event or Problem · 1

MANUFACTURER REFERENCE NUMBER (B)(4).

Description of Event or Problem · 1

MANUFACTURER REFERENCE NUMBER (B)(4).

Description of Event or Problem · 1

MANUFACTURER REFERENCE NUMBER (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
778271 POWERLED LIGHT, SURGICAL, CEILING MOUNTED FSY MAQUET SAS ARD568330933
778272 POWERLED LIGHT, SURGICAL, CEILING MOUNTED FSY MAQUET SAS ARD568330933

Patients

Seq Age Sex Outcome Treatment
1 Unknown