FDA Adverse Event
Malfunction
Summary report: N
ENDOCARE CRYOCARE CRYOPROBE
MDR report key: 8170958
·
Received December 17, 2018
Report
- Report Number
- 3008262715-2018-00073
- Event Type
- Malfunction
- Date Received
- December 17, 2018
- Date of Event
- November 21, 2018
- Report Date
- November 21, 2018
- Manufacturer
- ENDOCARE INC.
- Product Code
- GEH
- PMA / PMN Number
- K153489
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
Narratives
Additional Manufacturer Narrative · 1
DEVICE EVALUATED BY SIMULATED USE TESTING. VACUUM SLEEVE FAILURE WAS THE CAUSE OF THE SHAFT FROSTING.
Description of Event or Problem · 1
SEVEN CRYOPROBES FAILED PRE-TEST DURING THE SAME CASE. ALL FROM THE SAME LOT NUMBER. COMPLAINT 7 OF 7.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1011692 | ENDOCARE CRYOCARE CRYOPROBE | UNIT, CRYOSURGICAL, ACCESSORIES | GEH | ENDOCARE INC. | PCS-17 | 26054 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 58 YR |