inforMED
InjuryKOA

BROOKS DILATOR

Received May 23, 2023 · Event occurred Apr 28, 2023

Report 2125050-2023-00609 · MDR key 16983384

Device

Generic name

Corpus Cavernosum Dilator, Reusable

Manufacturer

Coloplast A/s

Model number

QB93502400

Catalog number

QB9350

Lot number

8278064

Product problems

  • Adverse Event Without Identified Device or Use Problem
  • Adverse Event Without Identified Device or Use Problem

Patient

48 YR · Male

  • Perforation of Vessels
  • Perforation of Vessels

Narrative

Additional Manufacturer Narrative

THE LOT NUMBER WAS REVIEWED FOR COMPLAINT TREND, NONCONFORMING REPORT AND CAPA. DEVICES MET SPECIFICATION PRIOR TO RELEASE AND NO TRENDS WERE NOTED. WITHOUT THE BENEFIT OF EXAMINATION AND TESTING, COLOPLAST IS PRECLUDED FROM COMMENTING ON THE CONDITION OF THE DEVICE OR THE CAUSE OF THE OCCURRENCE. SHOULD ADDITIONAL FACTS PROMPT US TO ALTER OR SUPPLEMENT ANY INFORMATION OR CONCLUSIONS CONTAINED IN THE ORIGINAL MDR OR IN ANY PRIOR SUPPLEMENTAL REPORTS, A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem

ACCORDING TO AVAILABLE INFORMATION, THE PATIENT WITH THIS DEVICE EXPERIENCED A URETHRAL PERFORATION. THIS DEVICE WAS USED TO DILATE THE PATIENT FOR ANOTHER DEVICE IMPLANT. ONLY THE RESERVOIR WAS ABLE TO BE IMPLANTED AND THE PROCEDURE WAS ABORTED DUE TO THE PERFORATION. NO OTHER ADVERSE PATIENT EFFECTS WERE REPORTED.