SLT LARGE DIAMETER FLEXIBLE ENDOSCOPIC FIBER FEF-LARGE GRP8

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1992-04-23 for SLT LARGE DIAMETER FLEXIBLE ENDOSCOPIC FIBER FEF-LARGE GRP8 manufactured by Surgical Laser Technologies-slt.

Event Text Entries

[490] During laser removal of the gallbladder the saphire tip and screw assembly seperated from the optical fiber. The attached saphire tip fell into the space formally occupied by the gall bladder, the doctor took prompt action and located the tip assembly and recovered the assembly from the patient. The physician then carefully examined the area for any signs of tissue damage. No injury was found. The examination was completed using the high defination television camera and checks of the area revealed no signs of burns due to the flow of event during the procedure. No outstanding difficulties were encountered. This fiber will be examined by our slt representative as to possible cause and/or quality control improvements. The insertation tool will be examined by the manufacturer as to the condition internal guide and control tensions on the instrumentdevice labeled for single use. Patient medical status prior to event: satisfactory condition. There was not multiple patient involvement. Invalid data - on device service/maintenance. No data - regarding date last serviced. Service provided by: invalid data. Invalid data - service records availability. No imminent hazard to public health claimed. Device used as labeled/intended. Device was evaluated after the event. Method of evaluation: actual device involved in incident was evaluated, mechanical tests performed, visual examination, other. Results of evaluation: component failure, telemetry failure, none or unknown, none or unknown. Conclusion: device failure directly contributed to event. Certainty of device as cause of or contributor to event: yes. Corrective actions: device returned to manufacturer/dealer/distributor, user education provided, inserviced by biomedical engineering dept. Staff. The device was not destroyed/disposed of.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number524
MDR Report Key524
Date Received1992-04-23
Date of Report1992-04-08
Date of Event1992-04-01
Date Facility Aware1992-04-01
Report Date1992-04-08
Date Reported to FDA1992-04-08
Date Reported to Mfgr1992-04-07
Date Added to Maude1992-05-07
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 NameSLT LARGE DIAMETER FLEXIBLE ENDOSCOPIC FIBER
Generic NameLASER FIBER-600 MICRON-CONTACT SCAPEL
Product CodeGDB
Date Received1992-04-23
Model NumberFEF-LARGE
Catalog NumberGRP8
Lot Number1103010
ID NumberNA
OperatorOTHER HEALTH CARE PROFESSIONAL
Device AvailabilityY
Device Age01-JAN-92
Implant FlagN
Device Sequence No1
Device Event Key517
ManufacturerSURGICAL LASER TECHNOLOGIES-SLT


Patients

Patient NumberTreatmentOutcomeDate
101. Other 1992-04-23

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