MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2019-05-07 for AFFIRM BREAST BIOPSY GUIDANCE SYSTEM STLC-00004 manufactured by Hologic, Inc.
[145541237]
Evaluation of the returned sample found that spring coupling, that joins the needle carriage assembly to the z-axis gears, had failed. This condition allowed the needle carriage assembly to freely fall, under the weight of needle carriage assembly and biopsy needle. Eco-39089 replaced the spring coupling issue on 01/29/2015. According to the dhr, the affirm upright in question was manufactured in may 2013 prior to the eco release.
Patient Sequence No: 1, Text Type: N, H10
[145541238]
It was reported that when positioning the patient for a breast biopsy, the needle was approximately 3 to 5 cm above the skin before the mechanical part of the z-axis broke. The needle penetrated the patient breast approximately 2 to 3 cm deep through the area of the breast intended to be entered for the biopsy. The needle was manually removed and no medical intervention was needed beyond normal biopsy wound care. A field engineer was dispatched to the site and the affirm system was replaced and is working as intended.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1220984-2019-00044 |
| MDR Report Key | 8587902 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2019-05-07 |
| Date of Report | 2019-04-17 |
| Date of Event | 2019-04-16 |
| Date Mfgr Received | 2019-04-17 |
| Device Manufacturer Date | 2013-05-01 |
| Date Added to Maude | 2019-05-07 |
| 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 | KRISTIN FORNIERI |
| Manufacturer Street | 36 & 37 APPLE RIDGE ROAD |
| Manufacturer City | DANBURY CT 06810 |
| Manufacturer Country | US |
| Manufacturer Postal | 06810 |
| Manufacturer Phone | 2037318491 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | AFFIRM BREAST BIOPSY GUIDANCE SYSTEM |
| Generic Name | BIOPSY GUIDANCE SYSTEM |
| Product Code | IZH |
| Date Received | 2019-05-07 |
| Returned To Mfg | 2019-04-24 |
| Model Number | STLC-00004 |
| Catalog Number | STLC-00004 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | HOLOGIC, INC |
| Manufacturer Address | 36 & 37 APPLE RIDGE ROAD DANBURY CT 06810 US 06810 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-05-07 |