OEM EST 18FR 400 SERIES 100CS 81-041418

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 2014-12-12 for OEM EST 18FR 400 SERIES 100CS 81-041418 manufactured by Deroyal Cientifica De Latinoamerica Sa Globla Park.

Event Text Entries

[5237644] Temperature probes are not reading properly. Esophageal stethoscopes. Vital temp 18fr ref 1011eu lot 9475716. The first failure occurred when i placed the es, then hooked up the monitor lead and got double dashes, i. E. No reading. I did some troubleshooting that indicated that the lead wire and the monitor were ok. I decided it must have been an isolated defect, because i hadn't seen it before, but decided to check the probes at room temperature prior to inserting what might be a useless monitor into someone's esophagus. There's a small but non-zero risk of complications from inserting even a functioning es into a patient. I opened this package and tested the probe. It read room temperature correctly, so i inserted the es into my patient. At first, the probe gave credible readings in the 35-367 c range. Suddenly the temperature began to vacillate all over the place, reading anywhere from 19 to 36 c. This was not associated with cautery or any other "normal" source of interference. I cannot rule out penetration of the liquid-proof barrier to the es at this time, which might expose the patient to stray currents induced in the lead wire or a spurious path to ground in the cautery.
Patient Sequence No: 1, Text Type: D, B5


[12723733] No further information is available at this time. Will provide follow ups if information becomes available.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number9613793-2014-00010
MDR Report Key4359855
Report Source05
Date Received2014-12-12
Date of Report2014-12-12
Date of Event2014-11-03
Date Facility Aware2014-11-03
Report Date2014-12-12
Date Mfgr Received2014-11-19
Date Added to Maude2015-01-05
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 FDA3
Event Location0
Manufacturer Phone8653622333
Manufacturer Street200 DEBUSK LANE
Manufacturer CityPOWEL TN 37849
Manufacturer CountryUS
Manufacturer Postal Code37849
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameOEM EST 18FR 400 SERIES 100CS
Generic NameSTETHOSCOPE, ESOPHAGEAL, WITH ELECTR
Product CodeBZT
Date Received2014-12-12
Catalog Number81-041418
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerDEROYAL CIENTIFICA DE LATINOAMERICA SA GLOBLA PARK
Manufacturer Address602 PARKWAY P.O. BOX 180-3006 LA AURORA, HEREDIA CS


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2014-12-12

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