CAVILON NO STING BARRIER FILM 3345N

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,user f report with the FDA on 2017-05-15 for CAVILON NO STING BARRIER FILM 3345N manufactured by 3m Health Care.

Event Text Entries

[75207290] Lot number was reported as either 2018-09na or 2018-07ma. For lot # 2018-09na, the expiration date is: 09/28/2018 and the manufacturer date is: 09/2015. For lot number 2018-07ma, the expiration date is: 07/28/2018 and the manufacturer date is: 07/2015. (b)(4). Current packaging states the following: warning! Extremely flammable caution, see instructions for use. There is also a orange flame symbol on the bottle. This product, 3345n is not sold in the u. S. ; the instructions for use contain only non-english languages.
Patient Sequence No: 1, Text Type: N, H10


[75207291] Customer reported that during surgery, a 3345n cavilon no sting barrier film wand caught fire when a diathermy knife was used in close proximity. Reportedly, the patient experienced redness and the surgeon's eyebrows were burnt. No additional information was available to date.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2110898-2017-00076
MDR Report Key6568183
Report SourceCOMPANY REPRESENTATIVE,USER F
Date Received2017-05-15
Date of Report2017-05-05
Date of Event2017-04-26
Date Mfgr Received2017-05-05
Date Added to Maude2017-05-15
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 ContactMS KAREN KRENIK, BSN
Manufacturer Street3M CENTER BUILDING 275-5W-06 2510 CONWAY AVE
Manufacturer CityST. PAUL MN 55144
Manufacturer CountryUS
Manufacturer Postal55144
Manufacturer Phone6517333091
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameCAVILON NO STING BARRIER FILM
Generic NameCAVILON NO STING BARRIER FILM
Product CodeKMF
Date Received2017-05-15
Catalog Number3345N
Lot Number2018-09NA OR 2018-07MA
Device Expiration Date2018-09-28
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
Manufacturer3M HEALTH CARE
Manufacturer Address2510 CONWAY AVE ST. PAUL MN 55144 US 55144


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2017-05-15

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