MAUDE Adverse Event Report: PHILIPS VOLCANO INTRASIGHT; SYSTEM, IMAGING, PULSED ECHO, ULTRASONIC

Model Number 797403

Device Problems Crack (1135); Sharp Edges (4013)

Patient Problem No Clinical Signs, Symptoms or Conditions (4582)

Event Date 02/25/2022

Event Type  malfunction  

Event Description

It was reported that the manufacturer's system's touchscreen monitor was cracked with a section missing and sharp edges observed.There was no patient present and there was no user injury reported.This product problem is being reported in an abundance of caution because the touchscreen monitor has a crack exposing sharp edges that can result in a potential for harm.

Manufacturer Narrative

This case was reviewed and investigated according to the manufacture¿s policy.No patient involvement.No patient involvement.Not applicable.Lot# and expiration date are not applicable.Not applicable; no patient involvement.At the customer site, a field service engineer replaced the cracked intrasight system's touchscreen monitor and tested it.Do not apply to this submission.Submission of this report does not, in itself, represent a conclusion by the manufacturer and/or authorized representative or the national competent authority that the content of this report is complete or accurate, that the medical device(s) listed failed in any manner and/or that the medical device(s) caused or contributed to an alleged death or deterioration in the state of the health of any person.

Event Description

This product problem is no longer reportable because no sharp edges were observed during the returned product evaluation.

Manufacturer Narrative

Blocks b1/b5/h1: based on the returned product evaluation, this is no longer reportable for a product problem/malfunction.Blocks d9/g3: the intrasight touchscreen monitor was returned for evaluation.Block h3: visual inspection found a cracked screen with missing material, but no sharp edges were noted as determined by a glove test.Block h6: medical device problem code corrected from 4013 (sharp edges) to 1135 (crack) based on the returned product evaluation.The complaint codes listed in the initial mdr remain acceptable (10- type of investigation, 3252- investigation findings, and 61- investigation conclusion).The probable cause is likely damaged from use.The device integrity can be affected by external factors such as device manipulation, its impact, and applied pressure associated with use and handling.Submission of this report does not, in itself, represent a conclusion by the manufacturer and/or authorized representative or the national competent authority that the content of this report is complete or accurate, that the medical device(s) listed failed in any manner and/or that the medical device(s) caused or contributed to an alleged death or deterioration in the state of the health of any person.

• Brand Name: INTRASIGHT
• Type of Device: SYSTEM, IMAGING, PULSED ECHO, ULTRASONIC
• Manufacturer (Section D): PHILIPS VOLCANO; 3721 valley centre drive #500; san diego CA 92130
• Manufacturer (Section G): VOLCANO CORPORATION; 2870 kilgore road; rancho cordova CA 95670
• Manufacturer Contact: danielle bullock ; 3721 valley centre drive #500; san diego, CA 92130
• MDR Report Key: 13891683
• MDR Text Key: 289177181
• Report Number: 3008363989-2022-00018
• Device Sequence Number: 1
• Product Code: IYO
• UDI-Device Identifier: 00845225012878
• UDI-Public: (01)00845225012878(11)200630(90)300000437313
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K190078
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Health Professional,Company Representative
• Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date: 07/26/2022

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 03/24/2022
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Model Number: 797403
• Device Catalogue Number: 797403
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Is the Reporter a Health Professional?: Yes
• Was the Report Sent to FDA?: No
• Date Manufacturer Received: 06/30/2022
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 06/30/2020
• Is the Device Single Use?: No
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1