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U.S. Department of Health and Human Services

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

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HOLOGIC, INC BREVERA SYSTEM; BIOPSY SYSTEM Back to Search Results
Model Number BREV200
Device Problem Failure to Obtain Sample (2533)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 12/27/2023
Event Type  Injury  
Event Description
It was reported that on december 27th a biopsy procedure was performed with a brevera system and the physician feel that the vacuum on the brevera system was not working properly and as expected.Despite precise needle positioning, they did not get any calcifications and the patient had to be rescheduled.No additional information available.
 
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.
 
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Brand Name
BREVERA SYSTEM
Type of Device
BIOPSY SYSTEM
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
MDR Report Key18546138
MDR Text Key333277847
Report Number1222780-2024-00023
Device Sequence Number1
Product Code KNW
UDI-Device Identifier15420045507753
UDI-Public(01)15420045507753(11)190315
Combination Product (y/n)N
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,Followup
Report Date 03/07/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberBREV200
Device Catalogue NumberBREV200
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 12/27/2023
Initial Date FDA Received01/19/2024
Supplement Dates Manufacturer Received12/27/2023
Supplement Dates FDA Received03/07/2024
Was Device Evaluated by Manufacturer? No
Date Device Manufactured03/15/2019
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Other;
Patient SexFemale
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