MAUDE MDR 5442236

MDR report key
5442236
Report number
9681860-2016-00001
Event key
0
Event type
3
Date of event
2016-01-14
Date received
2016-02-17
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
THOM MCNAMARA
Address
15 HAMPSHIRE STREET MANSFIELD MA 02048 US
Phone
508-508-5084
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
16003 LG BABY SHADE 50/B 200/CBABY SHADECOVIDIENFOKMI00625MI00625525801XY Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12016-02-170

Event Narratives#

N

Patient 1

SUBMIT DATE: 02/17/2016. AN INVESTIGATION IS CURRENTLY UNDERWAY. UPON COMPLETION, THE RESULTS WILL BE FORWARDED.

D

Patient 1

IT WAS REPORTED TO COVIDIEN ON (B)(6) 2016 THAT A CUSTOMER HAD AN ISSUE WITH A BABY SHADE. THE CUSTOMER REPORTS THAT THE PHOTOTHERAPY GLASSES DO NOT FIT TO THE OCULAR AREA SO THEY DO NOT PROTECT THE PATIENT FROM THE HARMFUL EFFECTS CAUSED BY PHOTOTHERAPY. THE PHOTOTHERAPY GLASSES ARE STUCK ON THE BABY'S SKIN AND THEY HAVE TO UNSTICK THEM EVERY 3 HOURS WHEN THE BABY IS FED. SOMETIMES PHOTOTHERAPY GLASSES ALSO STICK AND IS DANGEROUS TO THE PREMATURE SKIN.

N

Patient 1

THE SAMPLE RECEIVED WITH THIS COMPLAINT CONSISTED OF ONE UNOPENED POUCH WITH PHOTOTHERAPY EYE PROTECTOR (LARGE) PART NUMBER: MI00625. THE UNUSED MI00625 PART WAS 100% VISUALLY INSPECTED AND MET ALL REQUIREMENTS OF PRODUCT CONSTRUCTION. CONSEQUENTLY THE REPORTED CONDITION COULD NOT BE CONFIRMED. THE OBSERVED RATE OF OCCURRENCE FOR THIS ISSUE DOES NOT EXCEED THE EXPECTED RATE OF OCCURRENCE AS DOCUMENTED IN THE RISK MANAGEMENT FILE. THE MOST PROBABLE ROOT CAUSE OF PHOTOTHERAPY GLASSES NOT FITTING TO THE OCULAR AREA IS IN IMPROPER USE OF THE PRODUCT. IT IS WORTH NOTING THAT PAYING STRICT ATTENTION TO PRODUCT APPLICATION UTILIZING BOTH THE HYDROGEL AND PROVIDED HEADBAND STRAPS IN THE CORRECT POSITIONING AS IDENTIFIED ON THE POUCH WILL INCREASE PRODUCT EFFICACY. IT IS IMPORTANT TO NOTE THAT COVIDIEN OFFERS TWO SIZES OF BABY SHADES: SMALL (PRODUCT ID MI00575) AND LARGE (PRODUCT ID MI00625). THIS CUSTOMER COMPLAINT IS ON THE LARGE BABY SHADES WHICH IS MEANT TO BE USED ON LARGER BABIES AND NOT ON SMALLER PREMATURE BABY. THE SMALL SIZE OF BABY SHADES IS 2.9CM X 11.4 CM, WHEREAS THE LARGE IS 3.8CM X 14CM. THE LARGER SIZE OF BABY SHADES IS MADE TO FIT ON BIGGER BABIES. ADDITIONALLY, AS IDENTIFIED ON THE INSERT PROVIDED WITH THE PRODUCT IT IS A SINGLE USE PRODUCT AND IS NOT DESIGNED FOR RE-APPLICATIONS. SINCE THIS COMPLAINT IS UNCONFIRMED AND NO COMPLAINT TREND EXISTS AND A SPECIFIC ROOT CAUSE FOR THE OCCURRENCE CANNOT BE IDENTIFIED, NO CORRECTIVE ACTION IS REQUIRED AT THIS TIME. THIS COMPLAINT WILL BE RECORDED FOR TRACKING AND TRENDING PURPOSES.