MAUDE MDR 1556476

MDR report key
1556476
Report number
2150060-2009-00171
Event key
0
Event type
3
Date of event
2009-11-11
Date received
2009-12-07
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
GINNY STAMBERGER
Address
33 TECH. DR. IRVINE CA 92618 US
Phone
949-949-9497
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ASP AUTOMATIC ENDOSCOPE REPROCESSOR WITH PRINTERAER EQUIPMENTMINNTECH CORP.NVENA20301NAN N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12009-12-070

Event Narratives#

N

Patient 1

CAPITAL EQUIPMENT EVALUATED AT THE CUSTOMER SITE. THE CUSTOMER SUBSEQUENTLY REQUESTED SERVICE. THE FIELD SERVICE ENGINEER (FSE) FOUND THE UNIT WITH A FAULTY POWER RECEPTACLE AND CIRCUIT BREAKER. THE FSE REPLACED THE PARTS AND INSPECTED THE UNIT FOR WATER LEAKS; NO LEAKS WERE FOUND. THE FSE PROCESSED A SUCCESSFUL WASH AND A WASH/DISINFECT CYCLE, BOTH WITH AND WITHOUT A SCOPE. THE UNIT CONFORMED TO THE MFR'S SPECIFICATIONS. RESULT - CIRCUIT BREAKER.

D

Patient 1

THE CUSTOMER ALLEGED THE BASIN OVERFLOWED WITH WATER. THE CUSTOMER BELIEVED THE WATER SPILLED ONTO THE OUTLET. THERE WERE SPARKS AND SMOKE COMING FROM INSIDE THE UNIT, POSSIBLY DUE TO A WATER OVERFLOW, THE AREA WHERE THE PLUG CONNECTS TO THE UNIT WAS CHARRED. THE CUSTOMER WAS NOT AWARE OF ANY OVERFLOW SINCE HE WAS NOT PRESENT DURING THE EVENT. AS A PRECAUTION, THE HEALTHCARE WORKER, AT THE TIME, UNPLUGGED THE POWER CORD. THE CUSTOMER STATED THE PRONG TO THE POWER CORD INSIDE THE UNIT BROKE. THE CUSTOMER STATED NO INJURIES WERE INVOLVED. A SERVICE WAS NOT REQUESTED. THE CUSTOMER WILL REPAIR THE UNIT.