inforMED
MalfunctionDWZ

PROCURE ENDOMYOCARDIAL BIOPSY FORCEPS

Received May 28, 2021 · Event occurred Apr 28, 2021

Report 3005334138-2021-00327 · MDR key 11900308

Device

Generic name

Device, Biopsy, Endomyocardial

Manufacturer

St. Jude Medical

Model number

408296

Catalog number

408296

Lot number

9941140

Product problems

  • Mechanical Problem
  • Mechanical Problem

Patient

60 YR

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Description of Event or Problem

RELATED MANUFACTURER REPORT NUMBER: 3005334138-2021-00328. DURING THE BIOPSY OF RV MYOCARDIAL TISSUE, THE JAWS ON THE FORCEPS WOULD NOT CLOSE. THE DEVICE WAS REPLACED, BUT THE SAME ISSUE OCCURRED WITH THE SECOND DEVICE. THE CASE WAS UNABLE TO BE COMPLETED DUE TO THIS ISSUE. THERE WERE NO ADVERSE PATIENT CONSEQUENCES.

Additional Manufacturer Narrative

ADDITIONAL INFORMATION: G3, G6, H2, H3, H6 THE RESULTS OF THE INVESTIGATION ARE INCONCLUSIVE SINCE THE DEVICE WAS NOT RETURNED FOR ANALYSIS. THE DEVICE WAS MANUFACTURED ACCORDING TO SPECIFICATIONS AS SUPPORTED BY THE RECEIVING INSPECTION RESULTS. BASED ON THE INFORMATION RECEIVED, THE CAUSE OF THE REPORTED INCIDENT COULD NOT BE CONCLUSIVELY DETERMINED.