MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 07 report with the FDA on 2008-02-29 for EXOGEN COUPLING GEL 71034124 manufactured by Smith & Nephew, Inc., Orthopaedic Div..
[18579862]
It was reported that the pt had a localized reaction to the coupling gel.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1020279-2008-00070 |
| MDR Report Key | 1004517 |
| Report Source | 07 |
| Date Received | 2008-02-29 |
| Date of Report | 2008-02-21 |
| Date of Event | 2008-02-19 |
| Date Mfgr Received | 2008-02-21 |
| Date Added to Maude | 2008-03-06 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | MR. PHILLIPS EMMERT, |
| Manufacturer Street | 1450 BROOKS ROAD |
| Manufacturer City | MEMPHIS TN 38116 |
| Manufacturer Country | US |
| Manufacturer Postal | 38116 |
| Manufacturer Phone | 9013995296 |
| Manufacturer G1 | SMITH & NEPHEW, INC., ORTHOPAEDIC DIV. |
| Manufacturer Street | 1450 BROOKS ROAD |
| Manufacturer City | MEMPHIS TN 38116 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 38116 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | EXOGEN COUPLING GEL |
| Generic Name | ULTRASOUND COUPLING GEL |
| Product Code | LPQ |
| Date Received | 2008-02-29 |
| Model Number | NA |
| Catalog Number | 71034124 |
| Lot Number | 070232 |
| ID Number | NA |
| Operator | LAY USER/PATIENT |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Implant Flag | N |
| Date Removed | B |
| Device Sequence No | 1 |
| Device Event Key | 974558 |
| Manufacturer | SMITH & NEPHEW, INC., ORTHOPAEDIC DIV. |
| Manufacturer Address | 1450 BROOKS ROAD MEMPHIS TN 38116 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2008-02-29 |