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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BARD PERIPHERAL VASCULAR, INC. ENCOR BIOPSY PROBE; BIOPSY INSTRUMENT

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BARD PERIPHERAL VASCULAR, INC. ENCOR BIOPSY PROBE; BIOPSY INSTRUMENT Back to Search Results
Catalog Number ECP0110GV
Device Problem Detachment of Device or Device Component (2907)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 11/22/2023
Event Type  malfunction  
Event Description
It was reported that during the preparation of a stereo-guided breast biopsy through normal density tissue, the basket of the probe allegedly came off when tried to load the device onto the system.The procedure was completed using another device.There was no reported patient injury.
 
Manufacturer Narrative
The manufacturing location was selected as unknown due to system limitations.The manufacturing location for the encor product is adroit medical equipment.As the lot number for the device was provided, a review of the device history records will be performed.The return of the sample is pending.However, photo was provided for review.The investigation of the reported event is currently underway.(expiry date: 01/2025).Section a through f ¿ the information provided by bd represents all the known information at this time.Despite good faith efforts to obtain additional information, the complainant/reporter was unable or unwilling to provide any further patient, product, or procedural details to bd.H3 other text : device pending return.
 
Manufacturer Narrative
H10: the manufacturing location was selected as unknown due to system limitations.The manufacturing location for the encor product is adroit medical equipment.H10: manufacturing review: a manufacturing review was not required as this is the only complaint reported to date for this product and lot.Investigation summary: one encor biopsy probe and partial vacuum assembly were received for evaluation.It was noted that the saline cap and probe cover was not returned.During visual evaluation, the device was returned with the sample tissue chamber separated from the probe, the device was appeared to be clean, and the aperture appeared to be closed.No functional testing due to the nature of the complaint.Also, two electronic photos were provided and reviewed.The first photo shows the encor biopsy probe in which it was observed that the front seal cap was detached from the sample trap chamber.The second photo shows the labelling information which it verifies/matches with the trackwise details.Based on the provided photo, the reported detachment of device can be confirmed.Therefore, the investigation is confirmed for the reported detachment of device as the received photo and also the device returned for evaluation (observed from evaluation photos) shows the front seal cap detached from the sample trap chamber.A definitive root cause for the alleged detachment could not be determined based upon the provided information.Labeling review: as the reported event did not allege a labeling or use related issue, a labeling review is not required.H10: d4 (expiry date: 01/2025), g3.H11: h6 (method, result, conclusion).H11: section a through f ¿ the information provided by bd represents all the known information at this time.Despite good faith efforts to obtain additional information, the complainant/reporter was unable or unwilling to provide any further patient, product, or procedural details to bd.H3 other text : see h10.
 
Event Description
It was reported that during the preparation of a stereo guided breast biopsy procedure through normal density tissue, the basket of the probe allegedly came off when tried to load the device onto the system.The procedure was completed by using another device.There was no patient contact.
 
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Brand Name
ENCOR BIOPSY PROBE
Type of Device
BIOPSY INSTRUMENT
Manufacturer (Section D)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe 85281
Manufacturer (Section G)
UNKNOWN
BR  
Manufacturer Contact
brett curtice
800 w. rio salado pkwy
tempe, AZ 85281
4803032689
MDR Report Key18325291
MDR Text Key330551044
Report Number2020394-2023-01254
Device Sequence Number1
Product Code KNW
UDI-Device Identifier00801741086250
UDI-Public(01)00801741086250
Combination Product (y/n)N
Reporter Country CodeSF
PMA/PMN Number
K040842
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,Health Professional,User Facility,Company Representative
Reporter Occupation Physician
Type of Report Initial
Report Date 12/01/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/14/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberECP0110GV
Device Lot NumberVTHPG002
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received11/22/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient SexFemale
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