MAUDE MDR 6753904

MDR report key
6753904
Report number
9612030-2017-05130
Event key
0
Event type
3
Date received
2017-07-31
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
EDWARD ALMEIDA
Address
15 HAMPSHIRE STREET MANSFIELD MA 02048 US
Phone
508-508-5084
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1DEVONMARKER, SKINCOVIDIENFZZ31160545311605451714776064N N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12017-07-310

Event Narratives#

N

Patient 1

SUBMIT DATE: 7/31/17. AN INVESTIGATION IS CURRENTLY UNDER WAY; UPON COMPLETION THE RESULTS WILL BE FORWARDED.

D

Patient 1

THE CUSTOMER STATES THAT THESE MARKERS WERE FOUND TO BE LEAKING.

N

Patient 1

THERE WERE NO SAMPLES SUBMITTED WITH THIS COMPLAINT. THE COMPLAINT SHALL BE REOPENED IF A SAMPLE IS RECEIVED. THE DEVICE HISTORY RECORD (DHR) WAS REVIEWED, AND NO ABNORMAL PROCESS CONDITIONS WERE PRESENT DURING THE MANUFACTURING OF THE PRODUCT THAT COULD HAVE LED TO THE DEFECT DESCRIBED BY THE CUSTOMER. THE DHR REVIEW SHOWED THAT ALL ACCEPTANCE CRITERIA INSPECTIONS PER ESTABLISHED SAMPLING LEVELS WERE WITHIN ACCEPTABLE LIMITS DURING THE PRODUCTION PROCESS. SINCE A SAMPLE WAS NOT EVALUATED A ROOT CAUSE COULD NOT BE IDENTIFIED AND NO CORRECTIVE ACTIONS WERE DEEMED NECESSARY AT THIS MOMENT. THE CURRENT PROCESS IS RUNNING ACCORDING TO PRODUCT SPECIFICATIONS MEETING QUALITY ACCEPTANCE CRITERIA. A PRODUCTION NOTIFICATION WAS ISSUED TO ALL PERSONNEL TO ENSURE THAT THEY ARE AWARE ON THE CONDITION REPORTED BY THE CUSTOMER. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.