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MalfunctionGBL

OPEN-END URETERAL CATHETER

Received Jul 23, 2019 · Event occurred Jul 10, 2019

Report 1820334-2019-01760 · MDR key 8816789

Device

Generic name

Gbl Catheter, Ureteral, General & Plastic Surgery

Manufacturer

Cook Inc

Model number

G14274

Catalog number

020015

Lot number

9627372

Product problems

  • Contamination /Decontamination Problem
  • Contamination /Decontamination Problem

Patient

Not reported

  • No Patient Involvement
  • No Patient Involvement

Narrative

Additional Manufacturer Narrative

BLANK FIELDS ON THIS FORM INDICATE THE INFORMATION IS UNCHANGED, UNKNOWN OR UNAVAILABLE ADDITIONAL INFORMATION: D10. INVESTIGATION ¿ EVALUATION. A REVIEW OF COMPLAINT HISTORY, DEVICE HISTORY RECORD , QUALITY CONTROLS, AND A VISUAL INSPECTION WERE CONDUCTED DURING THE INVESTIGATION. ONE UNOPENED DEVICE WAS RETURNED FOR INVESTIGATION. THE RETURNED PACKAGING CONFIRMS THE REPORTED COMPLAINT DEVICE LOT NUMBER. THE VISUAL EXAMINATION CONFIRMED DARK COLORED FIBROUS FOREIGN MATTER THAT WAS FREE FLOATING INSIDE OF THE SEALED PACKAGE. ADDITIONALLY, A DOCUMENT BASED INVESTIGATION EVALUATION WAS PERFORMED. A SEARCH OF THE COMPLAINT DATABASE REVEALED NO OTHER COMPLAINTS RELATED TO THIS LOT NUMBER. THE DEVICE HISTORY RECORD WAS REVIEWED AND NO NON-CONFORMANCES WERE FOUND DURING THE PRODUCTION OF THIS LOT NUMBER. THE CAUSE FOR THE FOREIGN MATTER WAS CONTRIBUTED TO A PACKAGING EVENT. THE RISK ANALYSIS FOR THIS FAILURE MODE WAS REVIEWED, AND IT WAS DETERMINED THAT NO ADDITIONAL RISK MITIGATING ACTIVITY IS REQUIRED. COOK MEDICAL HAS NOTIFIED THE APPROPRIATE PERSONNEL AND WILL CONTINUE TO MONITOR THIS DEVICE VIA THE COMPLAINTS DATABASE FOR SIMILAR COMPLAINTS. THIS REPORT IS REQUIRED BY THE FDA UNDER 21 CFR PART 803 AND IS BASED ON UNCONFIRMED INFORMATION SUBMITTED BY OTHERS. NEITHER THE SUBMISSION OF THIS REPORT NOR ANY STATEMENT CONTAINED HEREIN IS INTENDED TO BE AN ADMISSION THAT ANY COOK DEVICE IS DEFECTIVE OR MALFUNCTIONED, THAT A DEATH OR SERIOUS INJURY OCCURRED, NOR THAT ANY COOK DEVICE CAUSED, CONTRIBUTED TO, OR IS LIKELY TO CAUSE OR CONTRIBUTE TO A DEATH OR SERIOUS INJURY IF A MALFUNCTION OCCURRED.

Description of Event or Problem

THERE IS NO NEW PATIENT OR EVENT INFORMATION TO BE REPORTED.

Additional Manufacturer Narrative

(B)(6). PMA/510K #: PREAMENDMENT. THIS REPORT INCLUDES INFORMATION KNOWN AT THIS TIME. A FOLLOW UP REPORT WILL BE SUBMITTED SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE..

Description of Event or Problem

AS REPORTED, PRIOR TO DISTRIBUTION TO A USER FACILITY THE DISTRIBUTOR FOUND FOREIGN MATTER INSIDE THE UNOPENED PACKAGE OF A OPEN-END URETERAL CATHETER. THIS DEVICE DID NOT MAKE PATIENT CONTACT.