TM-2100

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01 report with the FDA on 2014-11-19 for TM-2100 manufactured by Critikon De Mexico.

Event Text Entries

[13028149] Investigation revealed the runaway condition was able to be recreated when a high impedance ground connection (marginal ground connection) going from the drive to the encoder was simulated by adding a 24 ohm resistor in series with the ground line. The effect was a reduced encoder voltage causing the encoder not to function as intended. This resulted in a loss of commutation in the motor that caused the treadmill belt to run in an uncontrolled manner. The exact cause of the commutation loss is not known and the event has not been duplicated without the addition of resistance to the encoder ground line. A design mitigation has been proposed by (b)(4) that will detect commutation loss and disable the drive when the reported condition occurs. This mitigation will be implemented to correct the impacted treadmills in the field.
Patient Sequence No: 1, Text Type: N, H10


[19089508] The customer reported that a companion suffered injuries while attempting to assist a patient who was falling from a treadmill. The patient was undergoing a stress test at the time of the fall. The treadmill was still in motion at the time of the event. The companion required treatment, x-rays and prescribed nsaids and is receiving rehabilitation sessions of their injuries of dermal abrasion in left hip region ( dermal-epidermal 3 x 5cm ) and pain on palpation of the middle and lower costal (rib) area.
Patient Sequence No: 1, Text Type: D, B5


[19127707] Patient data not available; reporter email address is unknown; reporter occupation is unknown. A follow-up report will be submitted when the investigation is complete.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number3008729547-2014-00014
MDR Report Key4262436
Report Source01
Date Received2014-11-19
Date of Event2014-10-22
Date Mfgr Received2015-02-20
Device Manufacturer Date2014-05-01
Date Added to Maude2014-11-19
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactDEB LAHR
Manufacturer Street540 W. NORTHWEST HWY
Manufacturer CityBARRINGTON IL 60010
Manufacturer CountryUS
Manufacturer Postal60010
Manufacturer Phone8472774472
Manufacturer G1CRITIKON DE MEXICO
Manufacturer StreetS. DE R.L. DE C.V.
Manufacturer CityJUAREZ,
Manufacturer CountryMX
Single Use3
Remedial ActionRC
Previous Use Code3
Removal Correction Number1651104-03/16/15-002-C
Event Type3
Type of Report3

Device Details

Brand NameTM-2100
Generic NamePOWERED TREADMILL
Product CodeIOL
Date Received2014-11-19
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerCRITIKON DE MEXICO
Manufacturer AddressS. DE R.L. DE C.V. JUAREZ, MX


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2014-11-19

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