inforMED
MalfunctionGEE

HARRELL 7MM BRONCH BRUSH (20/CS)

Received Apr 23, 2024 · Event occurred Feb 27, 2024

Report 3007305485-2024-00061 · MDR key 19164023

Device

Generic name

Brush, Biopsy, General & Plastic Surgery

Catalog number

000140

Lot number

202304184

Product problems

  • Detachment of Device or Device Component
  • Detachment of Device or Device Component

Patient

NA · Unknown

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

Narrative

Description of Event or Problem

THIS COMPLAINT WAS CREATED DUE TO THE RECEIPT OF A MEDWATCH REPORT MW5152454 ON 25MAR24. THE REPORT WAS FOUND TO BE WRITTEN AGAINST THE 000140, HARRELL 7MM BRONCH BRUSH (20/CS) DEVICE THAT WAS BEING USED DURING AN UNKNOWN PROCEDURE ON 27FEB24. THE REPORT STATED, ¿HEAD CAME OFF INSIDE PATIENTS LEFT LOWER LOBE, DOCTOR RETRIEVED IT USING ION CATH, PULMONARY FORCEPS AND THERAPEUTIC BRONCHOSCOPE.¿. THERE WAS NO REPORT OF INJURY, MEDICAL INTERVENTION, OR EXTENDED HOSPITALIZATION TO THE PATIENT OR USER. THIS REPORT IS BEING RAISED ON THE REPORTED MALFUNCTION WITH POTENTIAL FOR INJURY UPON REOCCURRENCE.

Additional Manufacturer Narrative

THE DEVICE IS NOT EXPECTED TO BE RETURNED FOR EVALUATION AND REVIEW. HOWEVER, THE COMPLAINT INVESTIGATION IS NOT COMPLETE AT THIS TIME. A SUPPLEMENTAL AND FINAL REPORT WILL BE FILED FOLLOWING THE COMPLETION OF THE COMPLAINT INVESTIGATION. WE WILL CONTINUE TO MONITOR FOR TRENDS THROUGH THE COMPLAINT SYSTEM TO ASSURE PATIENT SAFETY.

Additional Manufacturer Narrative

THE DEVICE HAS NOT BEEN RETURNED TO DATE AND NO PHOTOGRAPHIC EVIDENCE HAS BEEN PROVIDED; THEREFORE, THE REPORTED EVENT CANNOT BE VERIFIED. THE MANUFACTURING DOCUMENTS FROM THE DEVICE HISTORY RECORD HAVE BEEN REVIEWED WITH SPECIAL ATTENTION TO THE MANUFACTURING AND INSPECTION OF THE PRODUCT. THE PRODUCT RELEASED FOR DISTRIBUTION WAS FOUND TO HAVE MET ALL SPECIFICATIONS PRIOR TO SHIPMENT. THIS IS THE ONLY COMPLAINT FOR THIS LOT NUMBER AND FAILURE MODE WITHIN THE PAST TWO YEARS. (B)(4). PER THE INSTRUCTIONS FOR USE, THE USER IS ADVISED TO INSPECT THE PEEL-POUCH FOR ANY DAMAGE THAT MAY HAVE OCCURRED DURING TRANSIT OR HANDLING. IF DAMAGED, DO NOT USE. WE WILL CONTINUE TO MONITOR FOR TRENDS THROUGH THE COMPLAINT SYSTEM TO ASSURE PATIENT SAFETY.

Description of Event or Problem

THIS COMPLAINT WAS CREATED DUE TO THE RECEIPT OF A MEDWATCH REPORT MW5152454 ON 25MAR24. THE REPORT WAS FOUND TO BE WRITTEN AGAINST THE 000140, HARRELL 7MM BRONCH BRUSH (20/CS) DEVICE THAT WAS BEING USED DURING AN UNKNOWN PROCEDURE ON (B)(6) 2024. THE REPORT STATED, ¿BRUSH HEAD CAME OFF INSIDE PATIENTS LEFT LOWER LOBE, DOCTOR RETRIEVED IT USING ION CATH, PULMONARY FORCEPS AND THERAPEUTIC BRONCHOSCOPE." THERE WAS NO REPORT OF INJURY, MEDICAL INTERVENTION, OR EXTENDED HOSPITALIZATION TO THE PATIENT OR USER. THIS REPORT IS BEING RAISED ON THE REPORTED MALFUNCTION WITH POTENTIAL FOR INJURY UPON REOCCURRENCE.