MAUDE MDR 4487163

MDR report key
4487163
Report number
1056069-2015-00005
Event key
0
Event type
3
Date of event
2015-01-06
Date received
2015-02-03
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
100
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
KENNETH REVENNAUGH, DIR
Address
3545 S.W. 47TH AVE. GAINESVILLE FL 32608 US
Phone
352-352-3523
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1DS ANTERIOR 3.0TAC2INVIVO CORPMOS9896-030-24082R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12015-02-0301. O

Event Narratives#

D

Patient 1

A SEDATED MALE PATIENT WAS POSITIONED FEET FIRST SUPINE AND SCANNED WITH ANTERIOR COIL FOR AN ABDOMEN EXAMINATION. AFTER THE EXAMINATION, NECROSIS OF THE SKIN ON THE UPPER RIGHT ARM WAS OBSERVED. WITH-IN A PATIENT HEATING QUESTIONNAIRE IT WAS MENTIONED THAT THE CABLE OF THE MENTIONED COIL WAS TOUCHING NEAR THE AFFECTED AREA.

N

Patient 1

(B)(4). METHOD, RESULTS, CONCLUSIONS: THE INVESTIGATION IS STILL ONGOING ON THIS EVENT. WHEN THE INVESTIGATION IS COMPLETED A F/U REPORT WILL BE SENT TO THE FDA.

N

Patient 1

PR#: 3(B)(4). BASED ON THE PROVIDED INFORMATION AND TESTS PERFORMED ON SITE THERE IS NO INDICATION OF A MALFUNCTION OF THE MR SYSTEM OR COIL. THE INJURY AS SUSTAINED BY THE PATIENT IS CAUSED BY A COMBINATION OF FACTORS. THE MAIN CAUSE IS CONSIDERED TO BE THE CLOSE PROXIMITY OF THE RIGHT UPPER ARM TO THE MAGNET BORE IN COMBINATION WITH THE DIRECT CONTACT WITH THE COIL CABLE TO THE AFFECTED AREA LED TO THE INJURY AS SUSTAINED BY THE PATIENT. PADDING WAS NOT USED BETWEEN THE COIL CABLE AND PATIENTS SKIN OR BETWEEN THE MAGNET BORE AND THE RIGHT UPPER ARM. OTHER FACTORS THAT CONTRIBUTED TO THE INJURY ARE: THE PATIENT HAD A HAMPERED THERMO-REGULATION AND WAS UNABLE TO ALERT THE OPERATOR BECAUSE HE WAS SEDATED. 5 SCANS ON HIGH SAR VALUE WERE CONDUCTED.