MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional report with the FDA on 2018-08-29 for SHUMACHER BIOPSY/RNGURLRG-TPSTR240MM ER064R manufactured by Aesculap Ag.
[118719862]
(b)(4). Manufacturing site evaluation: eight shumacher biopsy forceps we received. According to the customer the movement and the cutting performance of four of the eight forceps is not according to the warranted specifications. Intraoperatively a biopsy could not be taken out of the patient without pulling. This pulling caused pain for the patient. Four forceps out of batch 52413302 and four out of batch 52422427. All products are decontaminated and available for investigation. There is temporary damage to the patient that will heal fully and will most likely not negatively influence the patient in the future. There was a visual and a functional test performed for each forceps by the q-coordinator of the production plant. According to the test the cutting was performed using the test material. Two of the four forceps are cutting according to specifications. The movement of the jaw is hooking and not smooth. At one forceps, it is not possible to close the jaw, the blades are not fitting together. Here too, burrs on the moveable jaw parts can be found. The device quality and manufacturing history records have been checked for all available lot number. The device history file has been checked and found to be according to the specification valid at the time of production. Based on the information available as well as a result of the investigation the root cause of the failure is most probably related to a manufacturing error.
Patient Sequence No: 1, Text Type: N, H10
[118719863]
It was reported by the healthcare professional to the company sales representative "on 30/7 daphne arias called me. She is a specialized ward gynecology nurse. She told the sales representative that on 24/6 the (gynecologist) performed a colposcopy for which she used article number (b)(4). The upper part of the jaws did not fully close in the lower part. Therefore a biopsy could not be taken out of the patient without pulling it out. This pulling caused pain for the patient. " "on 18/7 the erasmus mc ordered 8 biopsy forceps. (order#: (b)(4)) during this procedure the doctor tried 4 of the 8 forceps and she noticed that 4 forceps did not close as they should. The sales representative picked up the 4 forceps, and the other 4 forceps seemed to work properly. 4 forceps were tried during surgery and the gynecologist noticed these 4 closed insufficiently. The sales representative checked the remaining 4 pcs and noticed that these 4 also close insufficiently. " all med watch submissions related to this report are: 9610612-2018-00383, 9610612-2018-00382, 9610612-2018-00405, 9610612-2018-00406, 9610612-2018-00407(this report).
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9610612-2018-00407 |
| MDR Report Key | 7830483 |
| Report Source | FOREIGN,HEALTH PROFESSIONAL |
| Date Received | 2018-08-29 |
| Date of Report | 2018-07-30 |
| Date of Event | 2018-07-24 |
| Date Facility Aware | 2018-08-06 |
| Date Mfgr Received | 2018-07-30 |
| Device Manufacturer Date | 2018-03-29 |
| Date Added to Maude | 2018-08-29 |
| 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 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS. NICOLE BROYLES |
| Manufacturer Street | 615 LAMBERT POINTE DRIVE |
| Manufacturer City | HAZELWOOD MO 63042 |
| Manufacturer Country | US |
| Manufacturer Postal | 63042 |
| Manufacturer G1 | AESCULAP AG |
| Manufacturer Street | PO BOX 40 |
| Manufacturer City | TUTTLINGEN, 78501 |
| Manufacturer Country | GM |
| Manufacturer Postal Code | 78501 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | SHUMACHER BIOPSY/RNGURLRG-TPSTR240MM |
| Generic Name | BIOPSY FORCEPS |
| Product Code | HFB |
| Date Received | 2018-08-29 |
| Returned To Mfg | 2018-08-03 |
| Model Number | ER064R |
| Catalog Number | ER064R |
| Lot Number | 52422427 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | 3 MO |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | AESCULAP AG |
| Manufacturer Address | PO BOX 40 TUTTLINGEN, 78501 GM 78501 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2018-08-29 |