MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2020-03-24 for OPTICROSS 8655 manufactured by Boston Scientific Corporation.
[184812638]
(b)(6). Device evaluated by mfr: the device was returned for evaluation. Device analysis revealed that the imaging window was found detached in the distal section. The distal housing of the transducer appears to be in good condition. Impedance testing shows a good unit wave form. Ilab test could not be performed due to the detachment in the lapjoint.
Patient Sequence No: 1, Text Type: N, H10
[184812639]
Reportable based on device analysis completed on 02mar2020. It was reported that lost image occurred. The 90% stenosed target lesion was located in the moderately tortuous left anterior descending coronary artery. An opticross imaging catheter was selected for use. During pullback, the screen became black and nothing was displayed. The procedure was completed with another of the same device. No patient complications were reported. However, device analysis revealed a detachment of the imaging window in the distal section.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2134265-2020-03770 |
| MDR Report Key | 9873630 |
| Report Source | HEALTH PROFESSIONAL |
| Date Received | 2020-03-24 |
| Date of Report | 2020-03-24 |
| Date of Event | 2020-01-21 |
| Date Mfgr Received | 2020-03-02 |
| Device Manufacturer Date | 2019-09-27 |
| Date Added to Maude | 2020-03-24 |
| 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 | JAY JOHNSON |
| Manufacturer Street | TWO SCIMED PLACE |
| Manufacturer City | MAPLE GROVE MN 55311 |
| Manufacturer Country | US |
| Manufacturer Postal | 55311 |
| Manufacturer Phone | 7634942574 |
| Manufacturer G1 | BOSTON SCIENTIFIC CORPORATION |
| Manufacturer Street | 2546 CALLE PRIMERA |
| Manufacturer City | ALAJUELA |
| Manufacturer Country | CS |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | OPTICROSS |
| Generic Name | CATHETER, ULTRASOUND, INTRAVASCULAR |
| Product Code | OBJ |
| Date Received | 2020-03-24 |
| Returned To Mfg | 2020-01-30 |
| Model Number | 8655 |
| Catalog Number | 8655 |
| Lot Number | 0024501812 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BOSTON SCIENTIFIC CORPORATION |
| Manufacturer Address | TWO SCIMED PLACE MAPLE GROVE MN 55311 US 55311 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-03-24 |