BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    OAF FIBER

    MDR report key: 8733686 · Received June 26, 2019

    Report

    Report Number
    3004378299-2019-00090
    Event Type
    Malfunction
    Date Received
    June 26, 2019
    Date of Event
    April 29, 2019
    Report Date
    November 20, 2019
    Manufacturer
    QUANTA SYSTEM S.P.A.
    Product Code
    GEX
    PMA / PMN Number
    K160513
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IT
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 0

    THE PROBLEM COULD BE TRACED TO A POTENTIAL MISHANDLING DURING REPROCESSING. WE ARE UNAWARE ABOUT OPERATOR INJURY.

    Description of Event or Problem · 0

    THE OPTICAL FIBER HAD A FAILURE THAT DID NOT ALLOW TO USE IT PROPERLY. NO ADVERSE EFFECTS TO PATIENT WERE REPORTED.

    Additional Manufacturer Narrative · 1

    THE PROBLEM WAS DUE TO A COMPONENT FAILURE. WE ARE UNAWARE ABOUT OPERATOR INJURY. WE ARE WAITING FOR ADDITIONAL INFORMATION FROM THE DISTRIBUTOR.

    Description of Event or Problem · 1

    THE OPTICAL FIBER HAD A FAILURE THAT DID NOT ALLOW TO USE IT PROPERLY. NO ADVERSE EFFECTS TO PATIENT WERE REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    531156 OAF FIBER OPTICAL LASER FIBER GEX QUANTA SYSTEM S.P.A. OAF402713 A390208

    Patients

    Seq Age Sex Outcome Treatment
    1