SPECTRE GROUP U180080D43 PD1880PL6A

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 2005-02-26 for SPECTRE GROUP U180080D43 PD1880PL6A manufactured by Golden Pacific Electronics.

Event Text Entries

[410728] Motion control, inc. Manufactures and sells class 1 electirc prosthetic devices for upper limb amputees. One the their devices, a controller for "below elbow" amputees, has the option to use a rechargeable battery, mounted inside the prosthesis. This battery is recharged (always while "off the patient") by plugging a battery charger into the a/c wall outlet, and into the access port on the prosthesis. The connection to the a/c wall outlet is made through an a/c wall adapter (i. E low vlotage transformer) that the company purchase directly from global pacific electronics, and is manufactured by spectre, inc. The company purchases the remainder of the battery/charger system from added value technologies, inc. By design, all conncetors within the battery/charger system disallow incorrect inter-connectivity. However, the a/c wall adapters the company received in dec. Of 2004 were the wrong part number (i. E. Off by 1 digit in the 10 digit part number) resulting in an incorrect dimension on the connector that interfaces with the charger. The incorrect dimension on the connector also allowed it to connect 'incorrerctly' to the access port on the prothesis, thus applying 18 volts directly across the rechargeable battery, without benefit of the charger circuitry. The prothesis wearer reports that they incorrectly plugged the a/c wall adapter directly into the access port on their prosthesis, bypassing the charger circuit and that after approximately five hours of charging in this manner, the internal battery exploded, and broke out in flames. The wearer quickly grabbed the prothesis and took it outside and extinguished the flames. No injury to the wearer or anyone else was reported. The incorrect digit in the a/c wall adapter part number is the result of an error on our source control drawing for the part. This error happened when re-specifying the part in nov. 2004. The wearer did not follow instructions properly for charging the battery. The combination of these two mistakes resulted in the problem. The comapny have corrected the source control drawing for the a/c wall adapter and have isolated/reworked all in-house product. The company have recalled, and have sent correct replacements for, the (20) incorrect a/c wall adapters that went to customers, having called/spoken with each customer directly, explaining the dangers of incorrect connection. The company have enhanced clarity of operating instructions for the battery charger end users, and have permanently affixed a label to the a/c wall adapter cord that show clearly the proper inter-connectivity of the battery/charger system. The company will review our sop-01 'engineering change orders' and look for opportunities to refine our methods, so as to minimize the likelhood of repeated errors in our review process. The company have made telephone contact with each customer, and have already recieved (11) a/c wall adapters back from customers. The company will continue to push on our customers to return the remaining (9) units.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1723997-2005-00001
MDR Report Key582174
Report Source05
Date Received2005-02-26
Date of Report2005-01-26
Date of Event2005-01-25
Date Mfgr Received2005-01-26
Device Manufacturer Date2004-12-01
Date Added to Maude2005-03-18
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 ContactCAESAR RIVERA
Manufacturer Street2401 S 1070 W.SUITE B
Manufacturer CitySALT LAKE CITY UT 84119
Manufacturer CountryUS
Manufacturer Postal84119
Manufacturer Phone8019782622
Manufacturer G1*
Manufacturer Street*
Manufacturer City*
Manufacturer Country*
Single Use3
Remedial ActionRL
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSPECTRE GROUP
Generic NameAC/DC WALL ADAPTER (POWER SUPPLY)
Product CodeIQZ
Date Received2005-02-26
Returned To Mfg2005-01-27
Model NumberU180080D43
Catalog NumberPD1880PL6A
Lot NumberUNK
ID NumberMC,INC.PN 1390032
OperatorLAY USER/PATIENT
Device AvailabilityR
Device Eval'ed by MfgrY
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key572017
ManufacturerGOLDEN PACIFIC ELECTRONICS
Manufacturer Address* PLACENTIA CA * US
Baseline Brand NameSPECTRE GROUP
Baseline Generic NameAC/DC WALL ADAPTER (POWER SUPPLY)
Baseline Model NoU180080D43
Baseline Catalog NoPD1880PL6A
Baseline IDMC,INC.PN 13900


Patients

Patient NumberTreatmentOutcomeDate
10 2005-02-26

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