FDA Adverse Event Malfunction Summary report: N

POLARIS DUAL CENTER

MDR report key: 8186 · Received August 11, 1993

Report

Report Number
8186
Event Type
Malfunction
Date Received
August 11, 1993
Date of Event
January 25, 1993
Report Date
February 5, 1993
Manufacturer
AMSCO COMPANY
Product Code
FTD
Product Problem
Yes
Report Source
User Facility report

Narratives

Description of Event or Problem · 1

DURING EXPLORATION OF LEFT MEDIAL THIGH WOUND (SECONDARY TO VASCULAR ANTASTOMOSIS AND ORIF AND PLATING OF LEFT FEMUR) A PIECE FROM THE OVERHEAD SPOTLIGHT FELL INTO THE PATINETS WOULD. THE INCISION WAS IRRIGATED WITH A NACI AND CEFAZOLIN SOLUTION. TO DATE NO INFECTION HAS DEVELOPED. THE LIGHTS ARE INSPECTED QUARTERLY AND WAS LAST INSPECTED ON OCTOBER 15, 1992.INVALID DATA - REGARDING SINGLE USE LABELING OF DEVICE. PATIENT MEDICAL STATUS PRIOR TO EVENT: SATISFACTORY CONDITION. THERE WAS NOT MULTIPLE PATIENT INVOLVEMENT.DEVICE SERVICED IN ACCORDANCE WITH SERVICE SCHEDULE. DATE LAST SERVICED: 01-OCT-92. SERVICE PROVIDED BY: INDEPENDENT FACTORY TRAINED/AUTHORIZED SERVICE ORGANIZATION. SERVICE RECORDS AVAILABLE.NO IMMINENT HAZARD TO PUBLIC HEALTH CLAIMED. DEVICE USED AS LABELED/INTENDED.DEVICE WAS EVALUATED AFTER THE EVENT. METHOD OF EVALUATION: ACTUAL DEVICE INVOLVED IN INCIDENT WAS EVALUATED, VISUAL EXAMINATION. RESULTS OF EVALUATION: INVALID DATA. CONCLUSION: DEVICE EVALUATED AND ALLEGED FAILURE COULD NOT BE DUPLICATED. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: YES. CORRECTIVE ACTIONS: DEVICE REPAIRED AND PUT BACK IN SERVICE. INVALID DATA - ON DEVICE DESTROYED/DISPOSED OF STATUS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 POLARIS DUAL CENTER SURGICAL SPOTLIGHT FTD AMSCO COMPANY POLARIS UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 25 YR Other