Model Number 0010-2400 |
Device Problems
Fracture (1260); Temperature Problem (3022); Appropriate Term/Code Not Available (3191)
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Patient Problem
No Consequences Or Impact To Patient (2199)
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Event Date 08/28/2018 |
Event Type
malfunction
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Event Description
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It was reported that during a prostate procedure, forward firing was and blinking of the fiber occurred.The console prompted a courtesy message that the fiber was overheating.There was no tissue present on the scope or fiber to cause overheating.No prostrate/bladder stone were present for laser beam to come in contact to cause overheating.The case was completed utilizing a second fiber without clinical consequences to the patient.
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Manufacturer Narrative
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Analysis of the returned device revealed the glass cap shows a circumferential fracture on the distal side of fiber/cap fusion zone of the bevel edge.The fiber proximal to fracture can rotate independently of outer flow tubing.The glass cap exhibits moderate devitrification at output window.The metal cap exhibits severe char on surface, and indications of slight melting on output window.The outer flow tubing open end exhibits minor scratch marks.Based on device analysis, the potential for forward firing may exist.The probable root cause was determined based on heat accumulation.Cap wear was accelerated due to anatomical/procedural factors (tissue contact and technique) encountered during the procedure which would limit the performance of the fiber.The identified issues noted above may activate the fiberlife function which would modulate the power showing a pulsing beam or system would be placed into standby mode.An evaluation conclusion code of cause cannot be traced to device was assigned to this investigation.
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Event Description
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It was reported that during a prostate procedure, forward firing and blinking of the fiber occurred after 137,280j of fiber use.The console prompted a courtesy message that the fiber was overheating.There was no tissue present on the scope or fiber to cause overheating.No prostrate/bladder stone were present for laser beam to come in contact to cause overheating.The tip of the fiber was cleaned during procedure the case was completed utilizing a second fiber without clinical consequences to the patient.
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Search Alerts/Recalls
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