FDA Adverse Event Malfunction Summary report: N

SAT XS 13

MDR report key: 8277048 · Received January 25, 2019

Report

Report Number
9710055-2019-00021
Event Type
Malfunction
Date Received
January 25, 2019
Date of Event
January 3, 2019
Report Date
February 12, 2020
Manufacturer
MAQUET SAS
Product Code
FSY
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

GETINGE BECAME AWARE OF AN INCIDENT WITH ONE OF ANCHORING, CEILING SYSTEM ¿ SATELITE. AS IT WAS STATED, THE END CAP DETACHED FROM THE DEVICE. THERE WAS NO INFORMATION ABOUT PATIENT INVOLVEMENT HOWEVER WE DECIDED TO REPORT THE ISSUE IN ABUNDANCE OF CAUTION AS ANY PARTS FALLING COULD LED TO SERIOUS INJURY. IT WAS ESTABLISHED THAT WHEN THE EVENT OCCURRED, THE DEVICE DID NOT MEET ITS SPECIFICATION AND IT CONTRIBUTED TO THE EVENT. THE PROVIDED INFORMATION DID NOT INDICATE THAT THE DEVICE WAS BEING USED FOR PATIENT TREATMENT WHEN THE EVENT TOOK PLACE. DURING THE INVESTIGATION IT WAS FOUND THAT IN THE PAST THE REPORTED SCENARIO HAS NEVER LED TO SERIOUS INJURY, NOR DEATH. OUR INVESTIGATION FINDS THAT A DETACHED END CAP WOULD BE MOST LIKELY CAUSED BY LACK OF MAINTENANCE OR IMPROPER HANDLING OF THE DEVICE. WE BELIEVE THAT REMAINING DEVICES ARE PERFORMING CORRECTLY IN THE MARKET. WE ALSO BELIEVE THAT IF THE MANUFACTURER RECOMMENDATIONS WOULD HAVE BEEN FOLLOWED THE INCIDENT COULD HAVE BEEN AVOIDED. GIVEN THE CIRCUMSTANCES AND THE FACT THAT THERE IS NO APPARENT TREND IN COMPLAINTS OF THIS NATURE WE SHALL CONTINUE TO MONITOR FOR ANY FURTHER EVENTS OF THIS NATURE AND DO NOT PROPOSE ANY FURTHER ACTION AT THIS TIME.

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

MANUFACTURER REFERENCE NUMBER 192055.

Description of Event or Problem · 0

ON (B)(6) 2019 (B)(4) BECAME AWARE OF AN INCIDENT WITH ONE OF PARTS OF SURGICAL LIGHT- SAT XS 13. AS IT WAS STATED, THE END CAP CAME OFF. THERE WAS NO INJURY REPORTED. WE DECIDED TO REPORT THE ISSUE IN ABUNDANCE OF CAUTION AS ANY PART FALLING INTO STERILE FIELD OR DURING PROCEDURE MIGHT BE A SOURCE OF CONTAMINATION. MANUFACTURER REFERENCE NUMBER: (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.

Additional Manufacturer Narrative · 1

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

Additional Manufacturer Narrative · 1

THE ISSUE IS STILL BEING INVESTIGATED BY MANUFACTURING SITE.

Additional Manufacturer Narrative · 1

THE ISSUE IS STILL BEING INVESTIGATED BY MANUFACTURING SITE.

Additional Manufacturer Narrative · 1

THE ISSUE IS STILL BEING INVESTIGATED BY MANUFACTURING SITE.

Additional Manufacturer Narrative · 1

THE ISSUE IS STILL BEING INVESTIGATED BY MANUFACTURING SITE.

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 INVESTIGATED BY MANUFACTURING SITE. (B)(4). EXEMPTION # E2018005. (B)(4).

Additional Manufacturer Narrative · 1

THE ISSUE IS STILL BEING INVESTIGATED BY MANUFACTURING SITE.

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).

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).

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
69696 SAT XS 13 LIGHT, SURGICAL, CEILING MOUNTED FSY MAQUET SAS

Patients

Seq Age Sex Outcome Treatment
1 Other