IONTOPHORESIS TREATMENT PATCH

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2012-03-27 for IONTOPHORESIS TREATMENT PATCH manufactured by Empi.

Event Text Entries

[2571419] On (b)(6) 2012, an iontophoresis treatment patch was placed on the base of the neck onto the right shoulder with iontophoresis treatment completed over 10 minutes at 1 unit and then the patch delivering medication slowly over approximately 3 hours. The pt returned on (b)(6) 2012 reporting to staff of a slight skin burn over the posterior right shoulder where the previous treatment was done. This wasn? T noticed by the pt until later in the day after receiving the iontophoresis treatment. No specific additional care was required for the outcome.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5024817
MDR Report Key2513017
Date Received2012-03-27
Date of Report2012-03-27
Date of Event2012-03-14
Date Added to Maude2012-04-03
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameIONTOPHORESIS TREATMENT PATCH
Generic NameTREATMENT PATCH ? HYBRESIS BY EMPI
Product CodeEGJ
Date Received2012-03-27
Lot Number199589-001 "87967"
ID NumberREFERENCE#: 199589
Device Expiration Date2013-01-08
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Sequence No1
Device Event Key0
ManufacturerEMPI
Manufacturer AddressEAST CKEARLAKE SD 57226 US 57226


Patients

Patient NumberTreatmentOutcomeDate
10 2012-03-27

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