FDA Adverse Event Injury Summary report: N

MICROWAVE ENDOMETRIAL ABLATION (MEA) SYSTEM

MDR report key: 856323 · Received May 29, 2007

Report

Report Number
9710493-2007-00007
Event Type
Injury
Date Received
May 29, 2007
Date of Event
April 25, 2007
Report Date
May 29, 2007
Manufacturer
MICROSULIS MEDICAL LTD.
Product Code
MNB
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE MEA SYSTEM RECORDS DATA FOR EACH PATIENT TREATMENT PROCEDURE, INCLUDING SYSTEM PARAMETERS AND PATIENT DATA ENTERED BY THE PHYSICIAN. THE COMPANY ANALYZED THE MEA SYSTEM'S TREATMENT DATA FILE ASSOCIATED WITH THIS EVENT. THE CONCLUSION OF THE ANALYSIS WAS THAT THE MEA SYSTEM WAS FUNCTIONING WITHIN OPERATING SPECIFICATIONS AT THE TIME OF THE TREATMENT, AND NO MALFUNCTIONS OR PERFORMANCE DEVIATIONS WERE PRESENT. THE APPLICATOR WAS DISPOSED OF BY THE USER AND THUS COULD NOT BE ANALYZED.

Description of Event or Problem · 1

PATIENT WAS TREATED WITH A SINGLE USE FEMWAVE APPLICATOR WITHOUT INCIDENT. USER FACILITY REPORTED THERMAL INJURY TO ADJACENT TISSUE, REQUIRING SURGICAL INTERVENTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MICROWAVE ENDOMETRIAL ABLATION (MEA) SYSTEM MICROWAVE ENDOMETRIAL ABLATION DEVICE MNB MICROSULIS MEDICAL LTD. NA UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 YR Required Intervention