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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: CONMED CORPORATION POOLE SUCTION INSTRUMENT; TUBE, ASPIRATING, FLEXIBLE, CONNECTING

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CONMED CORPORATION POOLE SUCTION INSTRUMENT; TUBE, ASPIRATING, FLEXIBLE, CONNECTING Back to Search Results
Catalog Number 0035040
Device Problem Unsealed Device Packaging (1444)
Patient Problem Not Applicable (3189)
Event Type  malfunction  
Manufacturer Narrative
One (1) poole suction instrument was returned for evaluation of "insufficient heatseal." the packaging lab results showed an opening in the seal area.Proper adhesive transfer was observed in the open seal area, indicating that the seal was initially properly formed.The open seal may have been created by the product pushing through the seal during shipping and handling.This device was manufactured 16-november-2015.  a review of the manufacturing documents from the dhr/lhr has verified the devices were produced according to current and approved procedures and material specifications.   non-conformances regarding the product's identity, quality, safety, effectiveness or performance were not identified during manufacture.Of the lot containing (b)(4) units only this one complaint has been received for this lot product and event description.A 2-year review of device family history revealed 12 complaints involving 15 devices of which 13 were confirmed or are pending evaluation of "insufficient heatseal." (b)(4).To date, there have been no serious injuries or death related to this reported problem.Nonetheless, to prevent future recurrences, an investigation has been opened to address this issue.The reported packaging anomalies were obvious to the distributor, prompting return of the devices for evaluation.Good clinical practice would include examination and verification of the product and its original packaging to ensure both are intact.This package was completely open and would prompt the end-user to discard and obtain a sterile package.As with all medical devices, examination of packaging occurs multiple times prior to use (shipping/receiving, distribution, storage and prior to use).In addition, good clinical practice would include examination and verification of the product and its original packaging to ensure both are intact.If the product and its packaging have been opened/damaged or altered, do not use the product and contact the manufacturer immediately.
 
Event Description
As reported by the distributor in (b)(4), during receiving and inspection of incoming products, 1 package containing a poole suction instrument was discovered to have "insufficient heatseal." there was no patient involvement in this reported problem, as the packaging anomaly was discovered during inspection at the distributor facility prior to distribution to an end-user.This report is being filed based on the potential for injury with recurrence.
 
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Brand Name
POOLE SUCTION INSTRUMENT
Type of Device
TUBE, ASPIRATING, FLEXIBLE, CONNECTING
Manufacturer (Section D)
CONMED CORPORATION
525 french road
utica NY 13502 5994
Manufacturer (Section G)
CONMED CORPORATION
525 french road
utica NY 13502 5994
Manufacturer Contact
kimber boss
525 french road
utica, NY 13502-5994
MDR Report Key6421917
MDR Text Key70750103
Report Number1320894-2017-00060
Device Sequence Number1
Product Code BYY
UDI-Device Identifier00653405000382
UDI-Public(01)00653405000382
Combination Product (y/n)N
Reporter Country CodeJA
PMA/PMN Number
K780724
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type distributor,foreign
Reporter Occupation Other
Type of Report Initial
Report Date 03/21/2017
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received03/21/2017
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator No Information
Device Expiration Date11/14/2020
Device Catalogue Number0035040
Device Lot Number201511161
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/24/2017
Is the Reporter a Health Professional? No
Date Manufacturer Received02/28/2017
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured11/16/2015
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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