MAUDE Adverse Event Report: PHILIPS ULTRASOUND, INC TRANSDUCER S7-3T; 21781A TEE PROBE ASSEMBLY

Model Number 989605406772

Device Problem Temperature Problem (3022)

Patient Problem No Patient Involvement (2645)

Event Type  malfunction  

Manufacturer Narrative

Return of the suspect transducer is anticipated.Evaluation of the transducer will be included in a follow up report upon its return and investigation completion.

Event Description

A customer reported an s7-3t model transducer displaying a tip temperature of zero degrees celsius.The discovery was made during installation and there was no patient involvement.

Manufacturer Narrative

A thorough investigation was performed to determine the root cause of the reported issue.The investigation determined a small number of s7-3t and s8-3t model transducers were not properly programmed during manufacturing which can result in an incorrect distal tip temperature.A notice was sent to all customers regarding this programming error.All affected transducers are being replaced to resolve this issue.This action was reported to fda per 21 cfr part 806 on 8/28/2019.Reference corrections and removal report number 3019216-2019/08/28-002-r.Submission of a report does not constitute an admission that medical personnel, user facility, importer, distributor, manufacturer, or product caused or contributed to the event.

Event Description

A customer reported an s7-3t model transducer displaying a tip temperature of zero degrees celsius.The discovery was made during installation and there was no patient involvement.3019216-2019/08/28-002-r.

• Brand Name: TRANSDUCER S7-3T
• Type of Device: 21781A TEE PROBE ASSEMBLY
• Manufacturer (Section D): PHILIPS ULTRASOUND, INC; 22100 bothell everett highway; bothell WA 98021
• MDR Report Key: 8724407
• MDR Text Key: 148926121
• Report Number: 3019216-2019-00035
• Device Sequence Number: 1
• Product Code: ITX
• UDI-Device Identifier: 00884838061439
• UDI-Public: (01)00884838061439
• Combination Product (y/n): N
• PMA/PMN Number: K132304
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: health professional
• Type of Report: Initial,Followup
• Report Date: 05/23/2019

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 06/21/2019
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Model Number: 989605406772
• Device Lot Number: B1ZD4C
• Was Device Available for Evaluation?: Yes
• Was the Report Sent to FDA?: No
• Date Manufacturer Received: 06/19/2019
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1