MAUDE MDR 6334693

MDR report key
6334693
Report number
1018233-2017-00455
Event key
0
Event type
3
Date of event
2017-01-17
Date received
2017-02-15
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
1
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
AMY GRAVLEY
Address
8195 INDUSTRIAL BLVD COVINGTON GA 30014 US
Phone
770-770-7707
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1BARD BARCHYSTAR BRACHYTHERAPY APPLICATOR NEEDLE, 18 GAUGE (50/CASE)BRACHYTHERAPY NEEDLEBARD REYNOSA S.A. DE C.V. -9617592IWJ918205REAT2315R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12017-02-150

Event Narratives#

N

Patient 1

THE DEVICE WAS NOT RETURNED FOR EVALUATION. THE DEVICE HISTORY RECORD WAS REVIEWED AND FOUND NOTHING THAT COULD HAVE CAUSED OR CONTRIBUTED TO THE REPORTED EVENT. THE INSTRUCTIONS FOR USE STATE THE FOLLOWING: "AFTER USE, THIS PRODUCT MAY BE A POTENTIAL BIOHAZARD. HANDLE AND DISPOSE OF IN ACCORDANCE WITH ACCEPTED MEDICAL PRACTICE AND WITH APPLICABLE LAWS AND REGULATIONS. INDICATIONS: FOR PLACEMENT OF RADIOACTIVE SEEDS IN TRANSPERINEAL IMPLANT PROCEDURES. CAUTION: USING THE STYLET WITH EXCESSIVE FORCE TO MANIPULATE LODGED SEEDS MAY DAMAGE THE SEED. CAUTION: NEEDLES ARE NOT INTENDED TO PENETRATE BONE. IF RESISTANCE IS ENCOUNTERED, VERIFY NEEDLE POSITION. DO NOT PUSH INTO BONE; THIS MAY CAUSE NEEDLE TO BEND OR BREAK. REPLACE NEEDLE IF CANNULA, OR POINT, IS DAMAGED." (B)(4). THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO BARD. THE DEVICE WAS NOT RETURNED.

D

Patient 1

IT WAS REPORTED THAT THERE WERE ONLY FOUR NEEDLES INSTEAD OF FIVE NEEDLES IN THE POUCH. THE PROCEDURE WAS PERFORMED WITH FOUR NEEDLES AND ALL SEEDS WERE IMPLANTED INTO THE PATIENT. THE PATIENT RECEIVED THE INTENDED DOSAGE.

N

Patient 1

THE INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE A SUPPLEMENTAL REPORT WILL BE FILED. CORRECTIONS: EVALUATION CODS, ADDITIONAL MFR NARRATIVE. THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO BARD. THE DEVICE WAS NOT RETURNED.

D

Patient 1

IT WAS REPORTED THAT THERE WERE ONLY FOUR NEEDLES INSTEAD OF FIVE NEEDLES IN THE POUCH. THE PROCEDURE WAS PERFORMED WITH FOUR NEEDLES AND ALL SEEDS WERE IMPLANTED INTO THE PATIENT. THE PATIENT RECEIVED THE INTENDED DOSAGE.

N

Patient 1

THE INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE A SUPPLEMENTAL REPORT WILL BE FILED. THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO BARD. THE DEVICE WAS NOT RETURNED.

D

Patient 1

IT WAS REPORTED THAT THERE WERE ONLY FOUR NEEDLES INSTEAD OF FIVE NEEDLES IN THE POUCH. THE PROCEDURE WAS PERFORMED WITH FOUR NEEDLES AND ALL SEEDS WERE IMPLANTED INTO THE PATIENT. THE PATIENT RECEIVED THE INTENDED DOSAGE.