MAUDE MDR 8537886

MDR report key
8537886
Report number
9610612-2019-00260
Event key
0
Event type
3
Date received
2019-04-22
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
100
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS. NICOLE BROYLES
Address
615 LAMBERT POINTE DRIVE HAZELWOOD MO 63042 US
Phone
314-314-3145
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1YASARGIL TI PERM STD-CLIP BAYO 9MMCEREBRO VASCULAR CLIPSAESCULAP AGHCHFT758TFT758T52126145Y R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-04-220

Event Narratives#

N

Patient 1

(B)(4). INVESTIGATION: THE INVESTIGATION WAS CARRIED OUT VISUALLY AND MICROSCOPICALLY. HERE WE FOUND NO MAL-ALIGNED JAW OR ANOTHER FAILURE. ADDITIONAL WE DETECTED TRACES OF USAGES. FURTHERMORE, THE IMPLANT WAS SENT TO THE QUALITY ASSURANCE OF THE PRODUCTION DEPARTMENT FOR A CLOSING FORCE TEST. THE CLOSING FORCE HAS BEEN EXAMINED WITH THE CHECK WEIGHER FOR CLIP ID (B)(4). ACCORDING TO SPECIFICATION (1.96 N +/- 7.5 % (MIN. 2.107 N, MAX. 1.813)) IS THE CLOSING FORCE IN THE ALLOWABLE TOLERANCE WITH 1.88 N. IN ADDITION, THE COMPLAINT COULD NOT BE RECONSTRUCTED WITH SCISSORING. BATCH HISTORY REVIEW: THE DEVICE QUALITY AND MANUFACTURING HISTORY RECORDS HAVE BEEN CHECKED FOR THE LOT NUMBER (52126145) AND FOUND TO BE ACCORDING TO THE SPECIFICATION, VALID AT THE TIME OF PRODUCTION. NO SIMILAR INCIDENTS HAVE BEEN FILED WITH PRODUCTS FROM THIS BATCH CONCLUSION AND ROOT CAUSE: NO FAILURE WAS FOUND. RATIONALE: DUE TO OUR INVESTIGATION NO FAILURE WAS FOUND. ACCORDING TO THE QUALITY STANDARD AND TO THE DHR FILES A PRODUCTION ERROR AND A MATERIAL DEFECT CAN BE EXCLUDED. SINCE THESE CLIPS ARE SUBJECT TO A 100% INSPECTION OF SURFACE, GEOMETRY AND CLOSING FORCE, A DELIVERY CONDITION WITH POOR GEOMETRY IS EXCLUDED. ACCORDING TO THE REPORT OF THE QUALITY ASSURANCE OF THE PRODUCTION DEPARTMENT THE INSTRUMENT COMPLIES WITH OUR SPECIFICATIONS. NO CAPA NECESSARY.

D

Patient 1

IT WAS REPORTED THE CLIP JAW WAS MALIGNED INTRAOPERATIVELY. THE REPORTER INDICATED THE SURGEON LOADED THE CLIP ON THE APPLIER, BUT BEFORE APPROACHING THE ANEURYSM NECK, IT WAS NOTICED THAT THE BLADES OF THE CLIP WERE NOT ALIGNED WITH EACH OTHER ("LIKE SCISSORING"). PER THE REPORTER, THE CLIP WAS TAKEN FROM THE ORIGINAL STERILE PACKAGE. THE CLIP WAS REPLACED WITH A NEW CLIP FROM A DIFFERENT BATCH NUMBER. THERE WAS NO HARM TO THE PATIENT. ADDITIONAL INFORMATION HAS BEEN REQUESTED, HOWEVER, NOT YET RECEIVED.