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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION REZUM; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES

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BOSTON SCIENTIFIC CORPORATION REZUM; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES Back to Search Results
Model Number G2200
Device Problem Material Integrity Problem (2978)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 07/05/2023
Event Type  malfunction  
Event Description
It was reported that during preparation for the procedure but after the patient had been sedated, the generator does not progress forward from the win screen even after rebooting.The procedure was then cancelled.Another device was brought in, and the patient was sedated again.The procedure was then completed.There were no patient complications.This event is being reported for aborted/cancelled procedure with a patient under anesthesia.
 
Manufacturer Narrative
The device is not available for analysis; therefore, no physical or visual analysis of the product could be performed.The reported device performance allegation cannot be confirmed.Based on the information available, a conclusion code of cause not established was assigned to this investigation.
 
Manufacturer Narrative
Upon receipt of this generator at our quality assurance laboratory, the device was thoroughly analyzed.Upon powering the generator on, windows would start but would not progress beyond that point.It was determined that there was an electrical issue with the single board computer (sbc).The sbc was replaced, and the device issue resolved.The generator then passed full functional and electrical safety testing.Based on analysis results, a probable cause of cause traced to component failure was assigned to this investigation.
 
Event Description
It was reported that, during preparation for the procedure and following patient sedation, the generator did not progress forward from the windows screen.Rebooting the generator did not resolve the issue.The procedure was then cancelled.Another device was brought in, and the patient was sedated again.The procedure was then completed.There were no patient complications.This event is being reported for aborted/cancelled procedure with a patient under anesthesia.
 
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Brand Name
REZUM
Type of Device
ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
NORTECH SYSTEM INC
nw 7791
1450
minneapolis MN 55485 7791
Manufacturer Contact
farshad fahimi
4100 hamline avenue north
building c
saint paul, MN 55112
MDR Report Key17414083
MDR Text Key319944586
Report Number2124215-2023-39907
Device Sequence Number1
Product Code GEI
UDI-Device Identifier08714729986874
UDI-Public08714729986874
Combination Product (y/n)N
Reporter Country CodeJA
PMA/PMN Number
K180237
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,Health Professional
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 11/01/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberG2200
Device Catalogue NumberG2200
Device Lot Number0000004723
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 07/07/2023
Initial Date FDA Received07/28/2023
Supplement Dates Manufacturer Received10/13/2023
Supplement Dates FDA Received11/01/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured02/02/2022
Is the Device Single Use? No
Type of Device Usage Reuse
Patient Sequence Number1
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