LIGHTSTIC 360 DIFFUSER UNK

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2002-08-26 for LIGHTSTIC 360 DIFFUSER UNK manufactured by Rare Earth Medical Inc.

Event Text Entries

[259368] This pt was being treated with photodynamic therapy (pdt) for esophageal cancer. Two separate devices (called the "lightstic 360 diffuser") were being used in the procedure, both of them made by cardiofocus, inc. According to mfr's literature, "this single-use-only fiberoptic device is intended to deliver laser energy to desired tissue. Delivery of the light is intended to photoactivate a drug contained in the targeted tissue as part of a pre-clinical photodynamic therapy procedure. " the tips (on the shaft portion) of both diffusers broke off during the endoscopic procedure. The tips that broke off of the primary devices were retrieved during or immediately following the surgery and were discarded. The remaining portions of both devices are being stored in the risk mgmt dept. By looking at the remaining portions of the two devices, the point where the breakage occurred on the shaft of each device appears blackened, as if burnt. The points of breakage on the two diffusers have the appearance of a blackened matchstick tip that had once been lighted. No complications resulted from this event, the surgery was not extended in any way and all device fragments were retrieved. Unfortunately, the broken-off tips, once retrieved, were discarded during or immediately following the surgery; however, the remaining portion of each of the two diffusers was preserved.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW1025976
MDR Report Key413390
Date Received2002-08-26
Date of Report2002-08-19
Date of Event2002-07-30
Date Added to Maude2002-08-30
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA0
Report to FDA0
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Sequence Number: 1

Brand NameLIGHTSTIC 360 DIFFUSER
Generic NamePHOTODYNAMIC THERAPY DIFFUSER
Product CodeLQJ
Date Received2002-08-26
Model NumberUNK
Catalog NumberUNK
Lot NumberUNK
ID NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Implant FlagN
Date RemovedA
Device Sequence No1
Device Event Key402441
ManufacturerRARE EARTH MEDICAL INC
Manufacturer Address126B MID-TECH DR WEST YARMOUTH MA 02673 US

Device Sequence Number: 2

Brand NameLIGHTSTIC 360 DIFFUSER
Generic NamePHOTODYNAMIC THERAPY DIFFUSER
Product CodeLQJ
Date Received2002-08-26
Model NumberUNK
Catalog NumberUNK
Lot NumberUNK
ID NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Age*
Implant FlagN
Date RemovedA
Device Sequence No2
Device Event Key402443
ManufacturerRARE EARTH MEDICAL INC.
Manufacturer Address126B MID-TECH DR WEST YARMOUTH MA 02673 US


Patients

Patient NumberTreatmentOutcomeDate
10 2002-08-26

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