inforMED
MalfunctionMVR

GEM MICROVASCULAR ANASTOMOTIC COUPLER

Received Mar 4, 2025

Report 1416980-2025-00937 · MDR key 21519002

Device

Generic name

Device,anastomotic,microvascular

Model number

GEM2754

Catalog number

511100300060

Lot number

ASKU

Product problems

  • Difficult to Open or Close
  • Difficult to Open or Close

Patient

51 YR · Female

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

Narrative

Description of Event or Problem

IT WAS REPORTED THAT A 3.0MM COUPLER DID NOT CLAMP TIGHTLY ONTO THE VEIN. THIS WAS OBSERVED DURING A FREE FLAP GRAFT PROCEDURE. A NEW COUPLER WAS USED TO CONTINUE THE PROCEDURE. THERE WAS NO REPORT OF PATIENT INJURY OR MEDICAL INTERVENTION ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS AVAILABLE.

Additional Manufacturer Narrative

B3/D10: THE EVENT OCCURRED DURING AN UNSPECIFIED DATE OF DECEMBER 2024. D4 LOT #: THE REPORTED LOT WAS MS-35211-4464; HOWEVER, THIS IS NOT A VALID LOT FOR THIS PRODUCT. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative

ADDITIONAL INFORMATION: H6, H11. H11: THE DEVICE WAS NOT RETURNED AND THE LOT NUMBER IS UNKNOWN; THEREFORE, A DEVICE ANALYSIS COULD NOT BE COMPLETED. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.