TALLER BRIDGE PLUG

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2009-12-09 for TALLER BRIDGE PLUG manufactured by Electri-cord Mfg. Co. Mn Office.

Event Text Entries

[1287820] (b) (4). Fda safety investigation of certain medical device power cords manufactured by electri-cord. So far the following companies have notified users that they may have the recalled electri-cord power cord on their equipment: (b) (4). I have followed the attached flow chart and have determined that the power cord/plug is affected by the fda recall and is exhibiting one of the characteristics as follows: if the plug has bent or cracked prongs, an outer sheath that is visibly burnt, a black residue, signs of excessive wear and tear. I have taken the following actions: contact of the medical device manufacturer or sales representative to report the power cord failure and to request the appropriate replacement/repair. I have removed the power plug/cord assembly, replaced with a verified correct component, safety tested, and returned equipment back into service. The (b) (4) supervisor has been notified of this work order for the need to report to the fda. (b) (4) dates of use: 3 years.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5015058
MDR Report Key1628915
Date Received2009-12-09
Date of Report2009-12-09
Date Added to Maude2010-03-17
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationBIOMEDICAL ENGINEER
Health Professional0
Initial Report to FDA3
Report to FDA0
Event Location0
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Generic NameAC POWER PLUG
Product CodeLDQ
Date Received2009-12-09
Model NumberTALLER BRIDGE PLUG
Lot NumberTALLER BRIDGE
Device AvailabilityY
Device Sequence No1
Device Event Key0
ManufacturerELECTRI-CORD MFG. CO. MN OFFICE
Manufacturer Address1190 EAGAN INDUSTRIAL ROAD EAGAN MN 55121 US 55121


Patients

Patient NumberTreatmentOutcomeDate
101. Deathisabilit 2009-12-09

© 2024 FDA.report
This site is not affiliated with or endorsed by the FDA.