MAUDE Adverse Event Report: VERATHON MEDICAL ULC SPECTRUM SMART CABLE; LARYNGOSCOPE, RIGID

Model Number 0800-0543

Device Problems Break (1069); No Display/Image (1183)

Patient Problem No Clinical Signs, Symptoms or Conditions (4582)

Event Date 10/27/2020

Event Type  malfunction  

Manufacturer Narrative

The device return is anticipated, however; at the time of the report the device has not been received by verathon.Verathon continues to investigate the reported event and a supplemental report will be submitted in accordance with 21 cfr 803.56 when additional information becomes available.

Event Description

The customer reported that during a patient procedure, using a spectrum smart cable, the cable's connector broke off in the middle of the intubation.Though questioned, the customer could not specify which connector end broke off.The procedure was completed using another spectrum smart cable which was made available in an unspecified amount of time.No harm to the patient or user was reported.

Manufacturer Narrative

A replacement glidescope spectrum smart cable was provided to the customer and the spectrum smart cable used in the procedure was returned to verathon for evaluation.A verathon technical service representative evaluated the returned spectrum smart cable and confirmed that the cable was missing the hdmi connector.No indication was provided as to how the hdmi connector became separated from the cable.Since the customer had already received a replacement glidescope spectrum smart cable, the returned device was scrapped.No corrective action is required at this time.Verathon will continue to monitor for trends.

• Brand Name: SPECTRUM SMART CABLE
• Type of Device: LARYNGOSCOPE, RIGID
• Manufacturer (Section D): VERATHON MEDICAL ULC; 2227 douglas road; burnaby, british columbia V5C 5 A9; CA V5C 5A9
• MDR Report Key: 10929847
• MDR Text Key: 219323586
• Report Number: 9615393-2020-00241
• Device Sequence Number: 1
• Product Code: CCW
• Combination Product (y/n): N
• PMA/PMN Number: EXEMPT
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: health professional,user faci
• Type of Report: Initial,Followup
• Report Date: 11/05/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 12/01/2020
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Model Number: 0800-0543
• Device Catalogue Number: 0800-0544
• Device Lot Number: N/A
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 12/21/2020
• Date Manufacturer Received: 12/23/2020
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1