OPTIFLEX III CPM 2090

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2010-06-28 for OPTIFLEX III CPM 2090 manufactured by Chattanooga Group.

Event Text Entries

[19929191] Customer ((b) (6) medical center) complained that power cord plug-in on unit, pulled out of unit and caught on fire. The unit was not in use at the time of discovery. No injury occurred and no patient was involved. The person who pulled out the cord was also not harmed. Device has malfunctioned and the device or a similar device marketed by the manufacturer would be likely to cause or contribute to a death or serious injury if the malfunction were to recur.
Patient Sequence No: 1, Text Type: D, B5


[20098477] Unit failed initial electrical safety testing. The iec connector was pulled out of its receptacle with burn marks on it. One pin was melted off making the connector unusable. A loose connection was found that could have been a contributing factor. The units grounding tested good with only. 5 ohms from frame to pin and. 8 ohms resistance to the end of the plug. Replaced the iec connector before continuing to test the unit and the unit passed wonderfully. Conclusion: the unit's iec connector failed to remain intact, and a connection was loose which is the cause of the fire. I believe the connection pulled loose and made direct contact with the frame of the unit.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1022819-2010-00009
MDR Report Key1743176
Report Source05
Date Received2010-06-28
Date of Report2010-06-28
Date of Event2010-03-23
Date Mfgr Received2010-03-23
Date Added to Maude2010-07-19
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional0
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer Street1430 DECISION STREET
Manufacturer CityVISTA CA 92081
Manufacturer CountryUS
Manufacturer Postal92081
Manufacturer Phone7607271280
Manufacturer G1CHATTANOOGA GROUP
Manufacturer Street4717 ADAMS RD.
Manufacturer CityHIXSON TN 37343
Manufacturer CountryUS
Manufacturer Postal Code37343
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameOPTIFLEX III CPM
Product CodeBXB
Date Received2010-06-28
Returned To Mfg2010-04-09
Model Number2090
Catalog Number2090
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerCHATTANOOGA GROUP
Manufacturer Address4717 ADAMS RD. HIXSON TN 37343 US 37343


Patients

Patient NumberTreatmentOutcomeDate
10 2010-06-28

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