MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2008-12-16 for DUO TOME SLIDELITE FIBER DELIVERY DEVICE 840-846 manufactured by Boston Scientific Corporation.
[1020977]
Laser fiber broke during case. Laser immediately put in stand-by mode by laser operator. No injuries. Device used for 100 minutes.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW5009322 |
| MDR Report Key | 1272507 |
| Date Received | 2008-12-16 |
| Date of Report | 2008-12-16 |
| Date of Event | 2008-10-16 |
| Date Added to Maude | 2009-01-15 |
| Event Key | 0 |
| Report Source Code | Voluntary report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | RISK MANAGER |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | DUO TOME SLIDELITE FIBER DELIVERY DEVICE |
| Generic Name | NONE |
| Product Code | LNK |
| Date Received | 2008-12-16 |
| Catalog Number | 840-846 |
| Lot Number | 66531207 |
| ID Number | M0068408460 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BOSTON SCIENTIFIC CORPORATION |
| Manufacturer Address | ONE BOSTON SCIENTIFIC PLACE NATICK MA 01760153 US 01760 1537 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2008-12-16 |