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U.S. Department of Health and Human Services

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

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HOLOGIC, INC BREVERA BREAST BIOPSY SYSTEM DISPOSABLE; 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 01/24/2024
Event Type  Injury  
Event Description
It was reported that on january 24th, a brevera procedure was performed and the brevera failed to collect tissue samples.The needle was changed out, and the 2nd needle produced grinding noises but did produce tissue samples.The patient will need to be rescheduled to complete the procedure.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.2 devices were involved in this event: 1222780-2024-00055.
 
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Brand Name
BREVERA BREAST BIOPSY SYSTEM DISPOSABLE
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
MDR Report Key18657886
MDR Text Key334728816
Report Number1222780-2024-00054
Device Sequence Number1
Product Code KNW
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K163052
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,User Facility
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 03/13/2024
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 NumberBREVDISP09
Device Catalogue NumberBREVDISP09
Device Lot Number23K03RA
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 01/24/2024
Initial Date FDA Received02/07/2024
Supplement Dates Manufacturer Received01/24/2024
Supplement Dates FDA Received03/13/2024
Was Device Evaluated by Manufacturer? No
Date Device Manufactured11/03/2023
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 Outcome(s) Other;
Patient SexFemale
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