VALLEY LAB E7506 *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2004-04-30 for VALLEY LAB E7506 * manufactured by Valley Lab.

Event Text Entries

[20931023] Pt was in surgery for a c-section. After the procedure the grounding pad was removed from pt's right leg and a burn measuring 1. 5cm x 0. 5cm was found below where the ground pad was located. Md made aware and orders rec'd including consult with a general surgeon.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number524638
MDR Report Key524638
Date Received2004-04-30
Date of Report2004-04-01
Date of Event2004-04-01
Date Added to Maude2004-05-14
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameVALLEY LAB
Generic NamePOLYHESIVE GROUND PAD
Product CodeHQP
Date Received2004-04-30
Model NumberE7506
Catalog Number*
Lot Number76333
ID Number*
Device Expiration Date2005-11-30
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeUNKNOWN
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key513766
ManufacturerVALLEY LAB
Manufacturer Address5920 LONGBOW DR BOULDER CO 80301 US


Patients

Patient NumberTreatmentOutcomeDate
101. Life Threatening; 2. Required No Informationntervention 2004-04-30

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