GEM MICROVASCULAR ANASTOMOTIC COUPLER
Received May 28, 2024 · Event occurred Apr 9, 2024
Report 1416980-2024-02554 · MDR key 19409133
Device
Generic name
Device, Anastomotic, Microvascular
Manufacturer
Synovis Micro Companies Alliance, IncModel number
GEM2753Catalog number
511100250060
Lot number
SP24A172004490
Product problems
- Disconnection
- Disconnection
Patient
NA · Unknown
- No Clinical Signs, Symptoms or Conditions
- No Clinical Signs, Symptoms or Conditions
Narrative
Description of Event or Problem
IT WAS REPORTED THAT A 2.5MM COUPLER DISASSOCIATED FROM THE APPLIER. THIS OCCURRED PRIOR TO PATIENT USE. TO RESOLVE THIS ISSUE, ANOTHER COUPLER WAS USED AND IT WORKED FINE. THERE WAS NO PATIENT INVOLVEMENT. NO ADDITIONAL INFORMATION IS AVAILABLE.
Additional Manufacturer Narrative
SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.
Additional Manufacturer Narrative
THE ACTUAL DEVICE WAS RECEIVED FOR EVALUATION. VISUAL INSPECTION WAS PERFORMED WHICH IDENTIFIED THE LEFT RING OF THE COUPLER NO LONGER SEATED IN THE JAW ASSEMBLY WHICH WOULD INDICATE THAT THE RING HAD DISLODGED FROM THE JAW ASSEMBLY. THERE WAS NO OBSERVED DAMAGE TO THE JAW ASSEMBLY. THE REPORTED CONDITION WAS VERIFIED. THE CAUSE OF THE CONDITION COULD NOT BE DETERMINED. A BATCH REVIEW WAS CONDUCTED AND THERE WERE NO DEVIATIONS FOUND RELATED TO THIS REPORTED CONDITION DURING THE MANUFACTURE OF THIS LOT. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.