inforMED
MalfunctionGDF

ATEC INTRODUCER LOCALIZATION SET SURESIGHT

Received Jul 21, 2016 · Event occurred Jun 23, 2016

Report 1222780-2016-00182 · MDR key 5813092

Device

Generic name

Surgical Needle Guide

Manufacturer

Hologic, Inc

Model number

0914-20-OB

Catalog number

ILS 0914-20-OB

Lot number

602503

Product problems

  • Detachment Of Device Component

Patient

Not reported

  • No Consequences Or Impact To Patient
  • No Consequences Or Impact To Patient

Narrative

Additional Manufacturer Narrative

THE DEVICE HAS NOT YET BEEN RETURNED THEREFORE, A FAILURE ANALYSIS OF THE COMPLAINT DEVICE CANNOT BE COMPLETED. IF THE DEVICE IS RETURNED AND EVALUATION COMPLETED, A SUPPLEMENTAL MEDWATCH WILL BE FILED. 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. (B)(4).

Description of Event or Problem

IT WAS REPORTED DURING A BREAST BIOPSY PROCEDURE (EXACT DATE UNKNOWN) THE OBTURATOR TIP FELL OFF OUTSIDE THE PATIENT PRIOR TO INSERTION. NO REPORT OF PATIENT INJURY.

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.