DANTEC NEEDLE ELECTRODE 9013S0012

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2017-03-14 for DANTEC NEEDLE ELECTRODE 9013S0012 manufactured by Natus Manufacturing Limited.

Event Text Entries

[69840580] The information provided below represents all of the known information at this time. The lot history record will be reviewed with special attention to the manufacturing and inspection of this product. Customer has also been contacted to provide the rest of the required information below. The following information have not been provided and have been noted by the customer as not known. There has been no adverse event reported for the use on the patient. As reported, the doctor had a needle stick. Concomitant medical products and therapy dates (excludes treatment of event) - customer response: we use these needles every day in our emg lab and have not had any problem before nor after this incident. Customer has confirmed that there were no relevant tests/laboratory data, including dates performed and no other relevant history, including preexisting medical conditions. Justification for not providing below information and applicable sections: serial # - this section is not applicable as the medical device does not have serial # unique identifier (udi) # - this section is not applicable as the medical device did not have the udi# present on the labelling at the time of manufacture if implanted date (mm/dd/yyyy) - this section is not applicable as the medical device is not implantable if explanted date (mm/dd/yyyy) - this section is not applicable as the medical device is not implantable reprocessor name and address - this section is not applicable as the medical device is not a single-use device that was reprocessed or reused on a patient if ind, give protocol # - this section is not applicable as the medical device is not ind adverse event term(s) - this section is not applicable to medical devices if remedial action initiated, check type - this section is not applicable as no remedial action was initiated if action reported to fda under 21 usc 360i(f), list correction/removal reporting number - this section is not applicable as there was no action reported under 21 usc 360i(f)
Patient Sequence No: 1, Text Type: N, H10


[69840581] Customer reported when they were putting back the dantec concentric needle back into the plastic sleeve the needle went through the sleeve and they got a needle stick. This happened on one occasion.
Patient Sequence No: 1, Text Type: D, B5


[73841235] Manufacturer narrative: no issues with the production of this lot of electrodes. The device was found to have met specifications prior to shipment. Visual inspection was carried out on 6 needles retained from the same lot. The needles were found to be correctly intacted inside the protective tubes. The tubes looked unblemished with no visual defects found. Pouches were also found to be acceptable. All in process inspections and testing were reviewed. No manufacturing anomalies were identified that may have caused or contributed to the reported event. This is the first event reported for this lot number to date. Patient was screened for communicable diseases and had none, so the resident physician did not require further medical intervention. No further hospitalisation. The physician did not develop an infection. The result of the investigation is inconclusive as the device was not returned for evaluation. Correcte data: reprocessor name and address has been filled out by mistake. The device is a single use and was not reprocessed and reused on a patient. Below manufacturer's details are not applicable in section. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number3005581270-2017-00004
MDR Report Key6401869
Report SourceHEALTH PROFESSIONAL
Date Received2017-03-14
Date of Report2016-09-15
Date Mfgr Received2017-03-08
Device Manufacturer Date2016-06-09
Date Added to Maude2017-03-14
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. MICHAEL GALVIN
Manufacturer StreetIDA BUSINESS PARK
Manufacturer CityGORT, CO. GALWAY H91PD92
Manufacturer CountryEI
Manufacturer PostalH91PD92
Manufacturer Phone3539164745
Manufacturer G1NATUS MANUFACTURING LIMITED
Manufacturer StreetIDA BUSINESS PARK
Manufacturer CityGORT, CO. GALWAY H91PD92
Manufacturer CountryEI
Manufacturer Postal CodeH91PD92
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameDANTEC NEEDLE ELECTRODE
Generic NameDANTEC DISPOSABLE CONCENTRIC NEEDLE ELECTRODE
Product CodeIKT
Date Received2017-03-14
Model Number9013S0012
Catalog Number9013S0012
Lot Number23A/16/D
Device Expiration Date2019-06-09
OperatorPHYSICIAN
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerNATUS MANUFACTURING LIMITED
Manufacturer AddressIDA BUSINESS PARK GORT, CO. GALWAY H91PD92 EI H91PD92


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2017-03-14

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