MAUDE MDR 6506494

MDR report key
6506494
Report number
8044004-2017-05002
Event key
0
Event type
3
Date of event
2017-03-22
Date received
2017-04-19
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
SHARON MURPHY
Address
15 HAMPSHIRE STREET MANSFIELD MA 02048 US
Phone
203-203-2034
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1MICROSTREAMORIDION MEDICALMNRCS08651-02CS08651-02Y R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12017-04-190

Event Narratives#

N

Patient 1

A GOOD FAITH EFFORT WILL BE MADE TO OBTAIN THE APPLICABLE INFORMATION RELEVANT TO THE REPORT. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

D

Patient 1

MEDTRONIC RECEIVED A REPORT THAT THE UNIT DID NOT GENERATE AN AUDIBLE ALARM. CUSTOMER INDICATED THERE WAS NO PATIENT INVOLVEMENT WITH THIS EVENT.

N

Patient 1

THE SAMPLE ASSOCIATED TO THIS REPORT WAS RECEIVED AND THE CUSTOMER REPORTED ISSUE COULD NOT BE DUPLICATED.? WE ARE UNABLE TO DETERMINE THE CAUSE FOR THIS SPECIFIC EVENT HOWEVER, MANUFACTURING CONTROLS ARE IN PLACE TO DETECT DAMAGE AND TO REDUCE THE POTENTIAL FOR OCCURRENCE DURING THE MANUFACTURING PROCESS. INFORMATION HAS BEEN ADDED TO THE DATABASE AND TRENDS WILL CONTINUE TO BE MONITORED. A GOOD FAITH EFFORT WILL BE MADE TO OBTAIN THE APPLICABLE INFORMATION RELEVANT TO THE REPORT. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

D

Patient 1

MEDTRONIC RECEIVED A REPORT THAT THE UNIT WAS NOT ALARMING, THEY HAD NO AUDIO. CUSTOMER INDICATED THERE WAS NO PATIENT INVOLVEMENT WITH THIS EVENT.