inforMED
MalfunctionNTN

SPYGLASS DISCOVER DIGITAL CONTROLLER

Received Nov 21, 2023 · Event occurred Oct 26, 2023

Report 3005099803-2023-06253 · MDR key 18185969

Device

Generic name

Led Light Source

Model number

M0054295R0

Catalog number

1614-03

Lot number

2103507367

Product problems

  • Connection Problem
  • Connection Problem

Patient

Unknown

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

Narrative

Additional Manufacturer Narrative

BLOCK H6 (IMPACT CODES): IMDRF IMPACT CODE F1001 IS BEING USED TO CAPTURE THE REPORTABLE EVENT OF ABORTED/CANCELLED PROCEDURE.

Description of Event or Problem

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A SPYGLASS DISCOVER DIGITAL CONTROLLER WERE USED IN THE PROCEDURE ON OCTOBER 26, 2023. DURING THE PROCEDURE, THE DIGITAL VISUAL INTERFACE (DVI) CONNECTION ON THE BACK OF THE CONTROLLER WAS FOUND TO BE FAULTY. THE PROCEDURE WAS NOT COMPLETED DUE TO THIS EVENT. THERE WERE NO PATIENT COMPLICATIONS REPORTED AS A RESULT OF THIS EVENT.