MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2018-05-09 for NEUROPEN NEUROENDOSCOPES 2120-025 manufactured by Medtronic Neurosurgery.
[107822809]
If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10
[107822810]
It was reported that there were many black dots on the image when using the video. It was stated there were multiple broken fibers on the device.
Patient Sequence No: 1, Text Type: D, B5
[108878320]
If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10
[108878321]
Additional information received reported that there was no injury to the patient and the patient's current status was they were doing fine.
Patient Sequence No: 1, Text Type: D, B5
[109619955]
The returned endoscope produced an image with black dots. It is unknown what caused the reported event. After cleaning the endoscope, the endoscope produced a clear image. If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10
[111003946]
All endoscope devices are 100% image tested at the time of manufacture. If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 2021898-2018-00244 |
| MDR Report Key | 7500272 |
| Report Source | HEALTH PROFESSIONAL |
| Date Received | 2018-05-09 |
| Date of Report | 2018-06-13 |
| Date of Event | 2018-05-01 |
| Date Mfgr Received | 2018-06-13 |
| Device Manufacturer Date | 2018-01-26 |
| Date Added to Maude | 2018-05-09 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | STACY RUEMPING |
| Manufacturer Street | 7000 CENTRAL AVENUE NE RCW215 |
| Manufacturer City | MINNEAPOLIS MN 55432 |
| Manufacturer Country | US |
| Manufacturer Postal | 55432 |
| Manufacturer Phone | 7635260594 |
| Manufacturer G1 | MEDTRONIC NEUROSURGERY |
| Manufacturer Street | 125 CREMONA DRIVE |
| Manufacturer City | GOLETA CA 93117 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 93117 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | NEUROPEN NEUROENDOSCOPES |
| Generic Name | ENDOSCOPE, NEUROLOGICAL |
| Product Code | GWG |
| Date Received | 2018-05-09 |
| Returned To Mfg | 2018-05-17 |
| Model Number | 2120-025 |
| Catalog Number | 2120-025 |
| Lot Number | E41817 |
| Device Expiration Date | 2019-07-31 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MEDTRONIC NEUROSURGERY |
| Manufacturer Address | 125 CREMONA DRIVE GOLETA CA 93117 US 93117 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2018-05-09 |