MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1996-05-17 for ABDUCTION PILLOW manufactured by Deroyal Industries.
[27010]
Pt underwent a left total hip procedure on 5/10/96. On the morning of 5/11/96, the pt was noted to have left foot drop. The physician indicated the pt probably has left peroneal nerve palsy secondary to a tight strap from the abduction pillow around the pt's left calf. He also stated that the pt is susceptible due to pre-op back problems.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 33962 |
MDR Report Key | 33962 |
Date Received | 1996-05-17 |
Date of Report | 1996-05-14 |
Date of Event | 1996-05-11 |
Date Facility Aware | 1996-05-13 |
Report Date | 1996-05-14 |
Date Added to Maude | 1996-07-10 |
Event Key | 0 |
Report Source Code | User Facility report |
Manufacturer Link | N |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 0 |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Single Use | 0 |
Previous Use Code | 0 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | ABDUCTION PILLOW |
Generic Name | ABDUCTION PILLOW WITH CONCAVE PILLOW |
Product Code | IOZ |
Date Received | 1996-05-17 |
Lot Number | UNKNOWN |
ID Number | M60-0250M |
Operator | HEALTH PROFESSIONAL |
Device Availability | Y |
Device Age | UNKNOWN |
Implant Flag | N |
Date Removed | B |
Device Sequence No | 1 |
Device Event Key | 35303 |
Manufacturer | DEROYAL INDUSTRIES |
Manufacturer Address | 200 DEBUSK LANE POWELL TN 37849 US |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Required No Informationntervention | 1996-05-17 |