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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BARD PERIPHERAL VASCULAR, INC. ENCOR BIOPSY PROBE; BIOPSY INSTRUMENT

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BARD PERIPHERAL VASCULAR, INC. ENCOR BIOPSY PROBE; BIOPSY INSTRUMENT Back to Search Results
Model Number ECP0112G
Medical Device Problem Code Device Contamination with Chemical or Other Material (2944)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/02/2020
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
As the lot number for the device was provided, a manufacturing review will be performed.The sample was not returned to the manufacturer for inspection/evaluation.Therefore, the investigation of the reported event is inconclusive.Based upon the available information, the definitive root cause for this event is unknown.The instructions for use (ifu) is adequate for the reported device/patient code(s) and provides general instructions for use, as well as warnings, precautions and potential complications associated with the device.Upon receipt of new or additional information, a follow-up report will be submitted as applicable.(expiry date: 01/2021).
 
Event or Problem Description
It was reported that prior to an ultrasound-guided breast biopsy, the device allegedly had a plastic material on the end of the needle.The procedure was completed using another device.There was no patient contact.
 
Additional Manufacturer Narrative
H10: manufacturing review: the device history records have been reviewed and this lot met all release criteria.There was nothing found to indicate there was a manufacturing related cause for this event.Investigation summary: one encor biopsy probe was returned for evaluation.A visual evaluation was performed.The biopsy probe appeared to have residue on the outside of the aperture and on the trocar tip.The sample was received with protective tubing.It was noted that the aperture was received closed.Scathing was noted to the inside of the protective tubing.The proximal retaining cap was glued to the probe.No damage was noted to the rear housing.No other anomalies were identified.The sample device was examined further under the microscope and foreign material was found to be on the aperture and cutter of the probe.Therefore, the investigation is confirmed for the alleged foreign material issue as it was noted a foreign material on the trocar tip.A definitive root cause for the reported failure could not be determined based upon the provided information.Labeling review: the review of the instructions for use, indications, warnings, precautions, cautions, possible complications, and contraindications showed that the product labeling is adequate.H10: (expiry date: 01/2021).H11: section a through f ¿ the information provide by bd represents all the known information at this time.Despite good faith efforts to obtain additional information, the complainant/reporter was unable or unwilling to provide any further patient, product, or procedural details to bd.
 
Event or Problem Description
It was reported that prior to an ultrasound-guided breast biopsy, the device allegedly had a plastic material on the end of the needle.The procedure was completed using another device.There was no patient contact.
 
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Brand Name
ENCOR BIOPSY PROBE
Common Device Name
BIOPSY INSTRUMENT
Manufacturer (Section D)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe AZ 85281
MDR Report Key10754523
Report Number2020394-2020-20292
Device Sequence Number11705409
Product Code KNW
UDI-Device Identifier00801741086267
UDI-Public(01)00801741086267
Combination Product (Y/N)N
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
K051158
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source company representative,health
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 01/21/2021
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
Operator of Device Health Professional
Device Model NumberECP0112G
Device Catalogue NumberECP0112G
Device Lot NumberVTDN0043
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer10/20/2020
Initial Date Received by Manufacturer 10/02/2020
Supplement Date Received by Manufacturer01/21/2021
Initial Report FDA Received Date10/29/2020
Supplement Report FDA Received Date02/17/2021
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
Outcome Attributed to Adverse Event Other;
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