FDA Adverse Event Other Summary report: N

GOODMAN CO LTD

MDR report key: 812450 · Received January 11, 2007

Report

Report Number
2243801-2006-00028
Event Type
Other
Date Received
January 11, 2007
Date of Event
October 4, 2006
Report Date
January 2, 2007
Manufacturer
B. BRAUN MEDICAL, INC.
Product Code
DYB
Removal / Correction Number
NA
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE ACTUAL DEVICE IN THE INCIDENT WAS RETURNED FOR EVAL. THE RETURNED UNIT DID NOT PASS PROXIMAL CONTINUITY TESTING. INVESTIGATION OF THE PROXIMAL ELECTRODE REVEALED THE PROXIMAL WIRE WAS DISCONNECTED. THERE WAS EVIDENCE THAT THE PROXIMAL WIRE WAS SOLDERED ENOUGH INSIDE THE ELECTRODE. MICROSCOPIC INVESTIGATION OF THE PROXIMAL WIRE SHOWED THAT THE PROPER AMOUNT (APPROXIMATELY 1.5MM FROM THE END OF THE WIRE) WAS SOLDERED INTO THE ELECTRODE. THIS DISCONNECTION MAY HAVE OCCURRED DURING MANIPULATION OF THE CATHETER UNITS. HOWEVER, NO SPECIFIC CONCLUSIONS CAN BE DRAWN.

Description of Event or Problem · 1

AFTER INSERTION OF A PACING CATHETER, UNABLE TO OBTAIN SENSING MEASUREMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GOODMAN CO LTD BIPOLAR PACING CATHETER, PUR DYB B. BRAUN MEDICAL, INC. NA 60840518

Patients

Seq Age Sex Outcome Treatment
1 YR Other