inforMED
MalfunctionFDS

ROTATING CONTINUOUS FLOW INNER SHEATH

Received Aug 12, 2014 · Event occurred Jul 23, 2014

Report 2951238-2014-00332 · MDR key 4071882

Device

Generic name

Inner Sheath

Manufacturer

Gyrus Acmi Inc.

Model number

GERIS-CF25

Catalog number

GERIS-CF25

Lot number

UNK

Product problems

  • Break

Patient

Not reported

  • No Consequences Or Impact To Patient

Narrative

Description of Event or Problem

THE USER FACILITY REPORTED THAT DURING A PROCEDURE, THE PLASTIC PIECE ON THE TIP OF THE INNER SHEATH BROKE OFF AND FELL INSIDE THE PATIENT. THE PLASTIC PIECE WAS RETRIEVED FROM THE PT. THERE WAS NO INJURY REPORTED. OLYMPUS FOLLOWED UP WITH THE USER FACILITY VIA PHONE IN AN EFFORT TO OBTAIN ADDITIONAL INFO REGARDING THE REPORTED EVENT WITH NO RESULTS.

Additional Manufacturer Narrative

THE DEVICE REFERENCE I THIS REPORT HAS NOT BEEN RETURNED TO OLYMPUS FOR EVALUATION. IF ADDITIONAL INFO IS RECEIVED AT A LATER TIME THIS REPORT WILL BE SUPPLEMENTED.