DUALOCK BREAST LOCALIZATION WIRE
Received Nov 23, 2015 · Event occurred Oct 27, 2015
Report 2020394-2015-01911 · MDR key 5244726
Device
Generic name
Breast Localization Wire
Manufacturer
Bard Peripheral Vascular, Inc.Catalog number
LW0077
Lot number
REYH2169
Product problems
- Activation Failure
Patient
Not reported
- No Known Impact Or Consequence To Patient
Narrative
Additional Manufacturer Narrative
AFTER FURTHER CLINICAL REVIEW, THIS EVENT WAS REASSESSED AND DETERMINED TO BE NOT MDR REPORTABLE. ALTHOUGH, THIS EVENT IS NOT MDR REPORTABLE, AN INITIAL MDR HAS ALREADY BEEN SUBMITTED; THEREFORE, THIS SUPPLEMENTAL REPORT IS BEING SUBMITTED TO DOCUMENT THE CHANGE IN REPORTABILITY AND ADDITIONAL PRODUCT DETAILS.
Additional Manufacturer Narrative
NO HOSPITAL/MEDICAL RECORDS OR MEDICAL IMAGES HAVE BEEN MADE AVAILABLE TO THE MANUFACTURER. AS THE LOT NUMBER FOR THE DEVICE WAS PROVIDED, A REVIEW OF THE DEVICE HISTORY RECORDS IS CURRENTLY BEING PERFORMED. THE DEVICE WILL NOT BE RETURNED TO THE MANUFACTURER FOR EVALUATION. THE INVESTIGATION OF THE REPORTED EVENT IS CURRENTLY UNDERWAY. THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO BARD.
Description of Event or Problem
IT WAS REPORTED THAT DURING A BREAST LOCALIZATION WIRE PROCEDURE, THE WIRE WAS DEPLOYED INTO THE BREAST BUT DID NOT EXPAND INTO ITS NORMAL CONFIGURATION. THE HCP DECIDED TO SEND THE PATIENT TO ANOTHER FACILITY TO PERFORM THE PROCEDURE AFTER THE WIRE FAILED TO EXPAND IN THE BREAST. THERE WAS NO REPORT OF PATIENT INJURY.