As reported, during a bladder biopsy and fulguration diagnostic procedure, the acmi monopolar cords (c650-129a) used with a bugbee electrode (acmi 257f8) caught fire during use.The incident occurred after brief intermittent use of instruments for several minutes.The cord was replaced with a different cord of the same kind.The intended procedure was completed with no harm or injury to the patient.No user injury reported.
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This report is being supplemented to provide additional information based on the legal manufacturer's final investigation.A review of the device history record found no deviations that could have caused or contributed to the reported issue.It has been over 10 years since the subject device was manufactured.Upon inspection, the complaint was confirmed.Based on the results of the investigation, the reported failure is likely due to the device being used beyond service life.This issue is addressed in the instructions for use (ifu): "when used as intended, this product is subject to wear or damage depending on the intensity of use.Inspect the product prior to each use to ensure it has no externally visible defects, including wear, kinks, cuts or pinching.Using this product when damaged may be hazardous;" and "this product has a restricted service life.Do not use the cable for a period of more than one year.Using the cable beyond one year may be hazardous." (cautions, page 1).Olympus will continue to monitor the field performance of this device.
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