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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: HOLOGIC, INC BREVERA; INSTRUMENT, BIOPSY

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HOLOGIC, INC BREVERA; INSTRUMENT, BIOPSY Back to Search Results
Model Number BREVDISP09
Device Problem Failure to Obtain Sample (2533)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 12/13/2023
Event Type  malfunction  
Event Description
It was reported that on december 13th, a biopsy procedure was performed, and during the procedure, two needles malfunctioned while they were in the patient's breast.The procedure was completed with another device.
 
Manufacturer Narrative
A device history record (dhr) review was conducted for the reported lot/serial number.The device was released meeting all qa specifications.We are currently unable to establish a relationship between the device and the issue reported.H3: the device involved in this event was not returned for evaluation purposes therefore visual and functional analysis of the product could not be performed.We are unable to confirm a relationship between the device and the issue reported and a definitive root cause for the reported event could not be determined.The information obtained during complaint investigation will be included in our global complaint trending and product surveillance will continue to monitor complaints of this type for adverse trends.If the product is received or additional information is obtained, the investigation will be reopened accordingly per standard operating procedure.2 devices were involved in this event: 1222780-2023-00477.
 
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Brand Name
BREVERA
Type of Device
INSTRUMENT, BIOPSY
Manufacturer (Section D)
HOLOGIC, INC
250 campus drive
marlborough MA 01752
Manufacturer (Section G)
HOLOGIC, INC.
250 campus drive
marlborough MA 01752
Manufacturer Contact
ariel lafuente
562 parkway
coyol free zone building b24
san jose 20102
CR   20102
MDR Report Key18421907
MDR Text Key331639039
Report Number1222780-2023-00478
Device Sequence Number1
Product Code KNW
Combination Product (y/n)N
Reporter Country CodeUK
PMA/PMN Number
K163052
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,User Facility
Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date 12/29/2023
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 NumberBREVDISP09
Device Catalogue NumberBREVDISP09
Device Lot Number23B23RA
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 12/13/2023
Initial Date FDA Received12/29/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured02/23/2023
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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