[20843315]
Third degree burns on her neck [burns third degree]. Blister was open and the skin was gone [burns second degree]. Peeling skin [skin exfoliation]. Redness [erythema]. Impetigo [impetigo]. Pus [wound secretion]. Constant sharp/stabbing pain [pain]. Would wear one wrap for 12 hours, take a break and then wear another [device misuse]. Case description: initial information was received from a consumer and additional information was received in the form of medical records and a consumer questionnaire. The patient is a female who used thermacare neck, shoulder and wrist heatwrap (lot # 8214u018s, expiration date 07/2011) for neck pain for 4 days in 2009. It was reported that the patient wore the wrap against her skin and that she would wear one wrap for 12 hours, take a two hour break and then wear another (device misuse/device misuse). At some point, during those three days, the patient experienced several second degree burns. There was no blistering, but she did notice peeling skin (skin exfoliation/skin exfoliation). The patient was taken to the hospital in the next day after the use, where she was diagnosed with a second degree burn. Treatment included an unspecified antibiotic cream and a tetanus shot. The patient was advised to change her dressing three times a day and to keep a close eye for any signs of infection. The patient has not recovered from the events. Of note, the patient was an experienced user who had previously used the back wraps without incident. No skin creams, ointments or oils were used by the patient. Consumer questionnaire revealed that the patient wore the wrap directly against her skin for five to six hours for three days. The patient denied sleeping with the wrap on and heating or re-heating the wrap in a microwave. The wrap was not worn on broken skin and the area was not bruised or swollen prior to application. The patient checked the skin frequently and did not detect any irritation or burning during use. The questionnaire noted that the patient had been diagnosed with a third degree burn (burns third degree/third degree burn). Medical records from the emergency room visit in 2009 revealed that the patient had a 2. 5cm by 4cm area of redness (erythema/redness) where a blister was open and the skin was gone (burns second degree/blisters, with epidermal loss due to burn (second degree) of neck). The diagnosis was an acute minor second degree burn. There was no evidence of surrounding cellulitis and no edema. The patient's sensation was intact. Treatment included burn/wound care, bactroban ointment, iodoform gauze dressing and a tetanus shot. She was discharged to home the same day, in stable condition. Medical records from the emergency room visit about 11 days later revealed that the patient was found to have pus on the gauze of her burn dressing (wound secretion/wound secretion). The patient's daughter stated she had a third degree burn on the back of her neck due to a thermal pack. A third degree burn on the back of her neck was noted during physical examination, but there was no evidence of cellulitis. The wound was cleaned with saline and dressed. A gram stain indicated moderate yeast (not candida albicans). A prescription was given for biaxin 500mg bid for 10 days and bactroban cream (30g) bid for 10 days. Two sutures which had been on her left ear were removed and a dressing was applied. The patient described her pain as constant sharp/stabbing pain (pian/pain) and her pain level was 3 out of 10. She was diagnosed with impetigo (impetigo/impetigo). The patient was referred to a plastic surgeon for further treatment. Her daughter was educated on use of aseptic techniques and pain control measures. The patient was discharged home with care notes on impetigo. The events were not recovered.
Patient Sequence No: 1, Text Type: D, B5