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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AESCULAP AG MINOP INVENT 30DG TROCAR D8.3MM L150MM; NEUROENDOSCOPY

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AESCULAP AG MINOP INVENT 30DG TROCAR D8.3MM L150MM; NEUROENDOSCOPY Back to Search Results
Model Number FH620R
Device Problem Product Quality Problem (1506)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Type  malfunction  
Manufacturer Narrative
Manufacturing site evaluation: investigation on-going.Additional information / investigation results will be provided in a supplemental report.
 
Event Description
It was reported that there was an issue with fh620r - minop invent 30dg trocar d8.3mm l150mm.According to the complaint description, the two components do not fit together and therefore cannot be used.Both individual parts seemed to have been in proper condition.There are adhesive residue on optics.There was no described patient harm.The malfunction is filed under aag reference (b)(4) associated medwatch-reports: 9610612-2021-00327 ((b)(4) + fh620r), 9610612-2021-00326 ((b)(4) + pe204a).
 
Event Description
The malfunction is filed under aag reference (b)(4).
 
Manufacturer Narrative
"investigation results/ visual investigation: the investigation was carried out visually and microscopically.A foreign substance can be found on the shaft of the endoscope.Visually, no deviation can be found at the trocar.The foreign substance at the shaft is probably adhesive, most likely caused by an improper montage of the endoscope.Furthermore, the measures of the endoscope has been checked, but partially found to be not according the specification.Therefore the failure described by the customer could be simulated, a montage of the components was not possible.Batch history review: review of the complaint history revealed that no similar complaints have been filed against products from this batch number.The need to revisit the risk assessment will be requested and further evaluated by the responsible department.Conclusion and measures / preventive measures: based upon the investigation results, the root cause of the reported issue can be traced back to a manufacturing-related failure.Specifically, it is assumed that the foreign body, on the shaft of the endoscope is most likely glue.This is not a systematic error.The dimensional deviations are manufacturing errors that have been reported to the manufacturer.A stock clearance has been initiated and the defective products have been sorted out.Based upon the investigations results a capa was initiated - further actions will be documented.Associated medwatch-reports: 9610612-2021-00327 ((b)(4) + fh620r) and 9610612-2021-00326 ((b)(4) + pe204a).
 
Manufacturer Narrative
Based upon investigation results, this event was re-evaluated and is considered no longer reportable due to risk file- no malfunction or serious injury.Investigation results: visual investigation: a foreign substance can be found on the shaft of the endoscope.Visually, no deviation can be found at the trocar.The foreign substance at the shaft is probably adhesive, most likely caused by an improper montage of the endoscope.Furthermore, the measures of the endoscope has been checked, but partially found to be not according the specification.Therefore the failure described by the customer could be simulated, a montage of the components was not possible.Batch history review: dhr check has been carried out in course the communication with the manufacturer.Review of the complaint history revealed that no similar complaints have been filed against products from this batch number.The review of the risk assessment revealed that the overall risk level (severity 2(5) x probability of occurrence 2(5)) according to din en iso 14971 is no longer acceptable.The need to revisit the risk assessment will be requested and further evaluated by the responsible department.Conclusion and measures / preventive measures: based upon the investigation results, the root cause of the reported issue can be traced back to a manufacturing-related failure.Specifically, it is assumed that the dimensional deviations are a manufacturing defect, which is communicated to the manufacturer and documented in the z2 messages 201974056, 201978630 and 201978631.A stock clearing was initiated and defective products were sorted out.Based upon the investigations results a product safety case (psc) was initiated.Associated medwatch-reports: 9610612-2021-00327 (400508674 + fh620r), 9610612-2021-00326 (400508675 + pe204a).
 
Event Description
The malfunction is filed under aag reference (b)(4).
 
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Brand Name
MINOP INVENT 30DG TROCAR D8.3MM L150MM
Type of Device
NEUROENDOSCOPY
Manufacturer (Section D)
AESCULAP AG
po box 40
tuttlingen, 78501
GM  78501
Manufacturer (Section G)
AESCULAP AG
po box 40
tuttlingen, 78501
GM   78501
Manufacturer Contact
christian von der grün
po box 40
tuttlingen, 78501
GM   78501
MDR Report Key11678918
MDR Text Key245862555
Report Number9610612-2021-00327
Device Sequence Number1
Product Code GWG
Combination Product (y/n)N
Reporter Country CodeIT
PMA/PMN Number
K983365
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Company Representative
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup,Followup
Report Date 11/30/2021
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
Device Operator Health Professional
Device Model NumberFH620R
Device Catalogue NumberFH620R
Device Lot Number52615118
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/19/2021
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 03/26/2021
Initial Date FDA Received04/16/2021
Supplement Dates Manufacturer Received07/08/2021
11/03/2021
Supplement Dates FDA Received08/12/2021
11/30/2021
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured10/12/2020
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
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