inforMED
MalfunctionGDF

ATEC INTRODUCER LOCALIZATION SET SURESIGHT

Received Apr 1, 2016 · Event occurred Jan 4, 2016

Report 1222780-2016-00078 · MDR key 5542734

Device

Generic name

Surgical Needle Guide

Manufacturer

Hologic, Inc

Model number

0914-20-OB

Catalog number

ILS 0914-20-OB

Lot number

509594

Product problems

  • Loose or Intermittent Connection

Patient

Not reported

  • No Known Impact Or Consequence To Patient
  • No Known Impact Or Consequence To Patient

Narrative

Additional Manufacturer Narrative

DEVICE HISTORY RECORD (DHR) REVIEW WAS CONDUCTED FOR THE REPORTED IDENTIFICATION NUMBER. THE LOT WAS RELEASED MEETING ALL QA SPECIFICATIONS. CURRENTLY UNABLE TO ESTABLISH A RELATIONSHIP OR IMPACT TO THE REPORTED OBSERVATION. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL MEDWATCH WILL BE FILED. WE ARE CURRENTLY IN THE PROCESS OF EVALUATING THE DEVICE AND WILL SEND A SUPPLEMENT REPORT WHEN COMPLETED. (B)(4).

Description of Event or Problem

IT WAS REPORTED COMPONENTS WERE LOOSE INSIDE THE ATEC-SURESIGHT UNOPENED PACKAGE.

Additional Manufacturer Narrative

THE RETURNED DEVICE WAS RECEIVED AND VISUALLY INSPECTED. THE INVESTIGATOR VERIFIED THAT THE DISTAL TIP OF THE OBTURATOR IS BROKEN. CAUSE IS PRESENTLY UNKNOWN FOR FAILURE. THE REPORTED OBSERVATION WAS CONFIRMED. THIS OBSERVATION IS BEING TRENDED AND MONITORED.