NOT DETERMINED

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-09-29 for NOT DETERMINED manufactured by Invivo Corporation.

Event Text Entries

[55989690] Event is under investigation and update will be provided on a later date.
Patient Sequence No: 1, Text Type: N, H10


[55989691] A sedated infant was scanned with the nvc 1. 5t coil head first in a supine position for a brain scan when the patient received a 2nd degree burn on their foot approximately 3cm blister.
Patient Sequence No: 1, Text Type: D, B5


[62827784] Based on the provided information and test performed on site, there is no indication of a malfunction of the coil used. No definite cause for the injury on the patient left leg could be determined. The coil was checked after the examination. The coil passed the performed tests. No damage was observed and the coil did not become too hot to touch. The spo2 sensor was close to the affected area but is not likely to have caused the injury. The sensor is mr safe and the monitoring device with the same accessories was used before and after the incident in a similar set up without problems. The patient was covered by a blanket of 100% polyester. The blanket may have contributed to the incident; however, the development of the blister was not observed as the area was covered with the blanket. Also, the blanket is made of polyester; polyester is an insulator and therefore hinders the heat dissipation. The blanket does not contain conductive materials. Neither the elephant application, nor the seams (yarn) are suspected to be conductive (judged by photographic evaluation). The nurse treated the affected skin area. The skin is expected to heal completely. The customer was informed to always follow the instructions for use of each accessory used during an examination. It is required even with mr conditional /safe equipment to prevent direct contact between cabling and the patient's body. Based on the provided information and test performed on site, there is no indication of a malfunction of the coil used.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1056069-2016-00003
MDR Report Key5988590
Date Received2016-09-29
Date of Report2016-09-07
Date of Event2016-08-29
Date Mfgr Received2016-08-30
Device Manufacturer Date2014-01-22
Date Added to Maude2016-09-29
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 Location3
Manufacturer ContactMR. KENNETH REVENNAUGH
Manufacturer Street3545 SW 47TH AVE
Manufacturer CityGAINSVILLE FL 32608
Manufacturer CountryUS
Manufacturer Postal32608
Manufacturer G1PHILIPS HEALTHCARE - INVIVO DIAGNOSTIC IMAGING
Manufacturer Street3545 SW 47TH AVE
Manufacturer CityGAINESVILLE FL 32608
Manufacturer CountryUS
Manufacturer Postal Code32608
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Generic NameNOT DETERMINED
Product CodeMOS
Date Received2016-09-29
Lot NumberN/A
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerINVIVO CORPORATION
Manufacturer Address3545 SW 47TH AVE GAINSVILLE FL 32608 US 32608


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2016-09-29

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