BACKJOY CORE

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2010-03-23 for BACKJOY CORE manufactured by Backjoy Core.

Event Text Entries

[16169141] On (b) (6) 2009, i purchased a product known as the backjoy after 3 months of using this product. I was hospitalized with blood clots in the left leg and in the lung. I remained in icu for 7 days (b) (6) 2010, until (b) (6) 2010 at (b) (6) hospital, (b) (6). I have had any problem in this manner until i purchased this product. Medical problems - pulmonary thrombo embolism and atrial fibrillation and pneumonia. I will have to take coumadin for next 6 month to 1 year, along with other medication. Dates of use: (b) (6) 2009 - (b) (6) 2010.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5015288
MDR Report Key1642745
Date Received2010-03-23
Date of Report2010-03-23
Date of Event2010-03-04
Date Added to Maude2010-04-02
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameBACKJOY CORE
Generic NameORTHOTIC SIT
Product CodeIPY
Date Received2010-03-23
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Sequence No1
Device Event Key0
ManufacturerBACKJOY CORE


Patients

Patient NumberTreatmentOutcomeDate
101. Hospitalization; 2. Life Threatening; 3. Other 2010-03-23

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