KTP/ND YAG LASER - ENDOSCOPIC LASER FIBER ENDO LASER FIBER 0.6MM X 12 FT

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1991-12-31 for KTP/ND YAG LASER - ENDOSCOPIC LASER FIBER ENDO LASER FIBER 0.6MM X 12 FT manufactured by Laserscope.

Event Text Entries

[45] 67 year old male, being treated in icu for multiple medical problems including a life-threatening and uncontrollable, tracheal hemorrhage fromerosion. On 12/10/91 the patient was taken to the or for a rigid bronchoscopy with laser. The et tube that was in place was changed due to blood clots and a #9 pvc tube placed. The procedure was then changed to a fiberoptic bronchoscopy with yag laser. The fiberoptic bronchoscopy was positioned approximately 1 cm distal to the et tube and the yag laser was situated 1cm distal to the tip of the fiberoptic bronchoscope. Wattage was set at 30, power set at 30 watts with one second pulses. After four or five doses of yag laser coagulation therapy, the tip of the et tube ignited and a tracheal fire occurred. Patient suffered thermal burns of the trachea, left mainstem bronchus, left upper lobe bronchus, and left lower lobe bronchus. This patient was critically ill and it was necessary during the procedure to deliver 100% oxygen. Patient expired 12/19/91 @ 1447device labeled for single use. Patient medical status prior to event: critical condition. There was not multiple patient involvement. Device serviced in accordance with service schedule. Date last serviced: 01-dec-91. Service provided by: manufacturer. Service records available. No imminent hazard to public health claimed. Device used as labeled/intended. Device was evaluated after the event. Method of evaluation: electrical tests performed, performance tests performed. Results of evaluation: end of life - expected, other, patient's condition - predisposed event. Conclusion: there was no device failure. Certainty of device as cause of or contributor to event: invalid data. Corrective actions: inserviced by other facility staff, invalid data. Invalid data - on device destroyed/disposed of status.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number127
MDR Report Key127
Date Received1991-12-31
Date of Report1991-12-23
Date of Event1991-12-10
Date Facility Aware1991-12-10
Report Date1991-12-23
Date Reported to FDA1991-12-23
Date Reported to Mfgr1991-12-11
Date Added to Maude1992-03-30
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional0
Initial Report to FDA0
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameKTP/ND YAG LASER - ENDOSCOPIC LASER FIBER
Product CodeLLO
Date Received1991-12-31
Model NumberENDO LASER FIBER 0.6MM X 12 FT
Lot Number02261-612-G13
ID NumberP/N 10-0612
OperatorOTHER HEALTH CARE PROFESSIONAL
Device AvailabilityY
Implant FlagN
Device Sequence No1
Device Event Key125
ManufacturerLASERSCOPE


Patients

Patient NumberTreatmentOutcomeDate
101. Death 1991-12-31

© 2024 FDA.report
This site is not affiliated with or endorsed by the FDA.