PERINEAL PAD LATERAL 72200718

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-05-18 for PERINEAL PAD LATERAL 72200718 manufactured by Smith & Nephew, Inc..

Event Text Entries

[75618079] Awaiting receipt of device.
Patient Sequence No: 1, Text Type: N, H10


[75618080] It was reported bruising of patient from lateral perineal pad being 'too firm'.
Patient Sequence No: 1, Text Type: D, B5


[79041618] Visual inspection and functional testing could not be performed because the device in question has not been returned for evaluation. Thus, the complaint could not be verified and a root cause could not be determined with confidence. It is difficult to perform an accurate evaluation of a failure without having the failed product to look at. As such the complaint is being closed without conclusion. However, if the product is returned in the future the complaint can be reopened and evaluated. Our quality department will continue to monitor for trends. No further investigation is required.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number3003604053-2017-00055
MDR Report Key6575479
Date Received2017-05-18
Date of Report2017-06-20
Date of Event2017-04-28
Date Mfgr Received2017-04-28
Date Added to Maude2017-05-18
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 Location3
Manufacturer ContactJIM GONZALES
Manufacturer Street7000 W. WILLIAM CANNON
Manufacturer CityAUSTIN TX 78735
Manufacturer CountryUS
Manufacturer Postal78735
Manufacturer G1SMITH & NEPHEW, INC.
Manufacturer Street150 MINUTEMAN ROAD
Manufacturer CityANDOVER MA 01810
Manufacturer CountryUS
Manufacturer Postal Code01810
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePERINEAL PAD LATERAL
Generic NameCOMPONENT, TRACTION, NON-INVASIVE
Product CodeKQZ
Date Received2017-05-18
Catalog Number72200718
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSMITH & NEPHEW, INC.
Manufacturer Address150 MINUTEMAN ROAD ANDOVER MA 01810 US 01810


Patients

Patient NumberTreatmentOutcomeDate
10 2017-05-18

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