SHANDON-LIPSHAW 222 *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1998-01-13 for SHANDON-LIPSHAW 222 * manufactured by Shandon-lipshaw.

Event Text Entries

[87041] It is suspected that the paraffin reached the flash point then caught fire, as a consequence of a faulty thermostat. This incident was duplicated by bio-med department.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number144359
MDR Report Key144359
Date Received1998-01-13
Date of Report1997-10-14
Date of Event1997-09-15
Date Facility Aware1997-10-14
Report Date1997-10-14
Date Reported to Mfgr1997-10-14
Date Added to Maude1998-01-20
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameSHANDON-LIPSHAW
Generic NamePARAFFIN DISP.
Product CodeIMC
Date Received1998-01-13
Model Number222
Catalog Number*
Lot Number*
ID NumberMFG. CODE 1389
OperatorOTHER
Device AvailabilityY
Device Age*
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key140771
ManufacturerSHANDON-LIPSHAW
Manufacturer Address171 INDUSTRY DR. PITTSBURGH PA 15275 US


Patients

Patient NumberTreatmentOutcomeDate
101. Other 1998-01-13

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