MAUDE Adverse Event Report: BARD ACCESS SYSTEMS REFURBISHED, SITE~RITE VISION II TOWER; SYSTEM, IMAGING, PULSED ECHO, ULTRASONIC

Model Number	N/A
Health Effect - Clinical Code	No Known Impact Or Consequence To Patient (2692)
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
The information provided by bard represents all of 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 bard.The device has not been returned to the manufacturer, at this time, for evaluation.A history review of serial number (b)(4) showed one other similar complaint(s) from this serial number.Device has not been returned, at this time.
Event or Problem Description
Biomed reported that vision ii tower is freezing up in sherlock mode during procedure causing the users to have to reboot in the middle of procedure.The system's touchscreen functions also intermittently scroll through options without command.The two reported issues may be related to the same root cause, although it cannot yet be determined until evaluated.
Additional Manufacturer Narrative
H11:section a through f - the information provided by bd represents all of 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.The following were reviewed as part of this investigation: patient severity, applicable previous investigation(s), sample (if available), applicable fmea documents, labeling, and applicable manufacture records.Based on a review of this information, the following was concluded: the device was returned to the service facility for evaluation.During evaluation, the reported issue of the tower is freezing up in sherlock mode is unconfirmed.The root cause of the reported failure is inconclusive as the reported issue could not be reproduced during evaluation.No other functionality issues with the equipment were found during evaluation/servicing.The device was serviced, tested and returned to refub inventory a history review of serial number (b)(4) showed one other similar complaint(s) from this serial number.
Event or Problem Description
Biomed reported that vision ii tower is freezing up in sherlock mode during procedure causing the users to have to reboot in the middle of procedure.The system's touchscreen functions also intermittently scroll through options without command.The two reported issues may be related to the same root cause, although it cannot yet be determined until evaluated.

• Brand Name: REFURBISHED, SITE~RITE VISION II TOWER
• Common Device Name: SYSTEM, IMAGING, PULSED ECHO, ULTRASONIC
• Manufacturer (Section D): BARD ACCESS SYSTEMS; 605 n. 5600 w.; salt lake city UT 84116
• MDR Report Key: 7920457
• Report Number: 3006260740-2018-02677
• Device Sequence Number: 13862944
• Product Code: IYN
• UDI-Device Identifier: 00801741125362
• UDI-Public: (01)00801741125362
• Combination Product (Y/N): N
• Initial Reporter Country: SP
• PMA/510(K) Number: K132942
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: user facility
• Initial Reporter Occupation: Biomedical Engineer
• Type of Report: Initial,Followup
• Report Date (Section B): 08/30/2019

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 Number: N/A
• Device Catalogue Number: 9770177R
• Device Lot Number: N/A
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 10/12/2018
• Event Location: Hospital
• Initial Date Received by Manufacturer: Not provided
• Supplement Date Received by Manufacturer: 08/30/2019
• Initial Report FDA Received Date: 09/28/2018
• Supplement Report FDA Received Date: 08/30/2019
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1