FDA Adverse Event Injury Summary report: N

MICROWAVE ENDOMETRIAL ABLATION (MEA) SYSTEM

MDR report key: 868725 · Received May 12, 2007

Report

Report Number
9710493-2007-00008
Event Type
Injury
Date Received
May 12, 2007
Date of Event
April 26, 2007
Report Date
June 21, 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

ADD'L CAT #: APPL. 900-002. ADD'L DEVICE MFR DATE: APPL. 10/2004. THE COMPANY ANALYZED THE MEA SYSTEM'S TREATMENT DATA FILE AND APPLICATOR ASSOCIATED WITH THIS EVENT. THE CONCLUSIONS OF THE ANALYSIS SHOWS THAT THE MEA SYSTEM WAS FUNCTIONING WITHIN OPERATING SPECIFICATIONS AT THE TIME OF THE TREATMENT, AND NO MALFUNCTIONS OR PERFORMANCE DEVIATIONS WERE PRESENT.

Description of Event or Problem · 1

PATIENT WAS TREATED WITH A REUSABLE MEA 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 NA

Patients

Seq Age Sex Outcome Treatment
1 YR Required Intervention