DR SCHOLLS

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,other report with the FDA on 2017-11-27 for DR SCHOLLS manufactured by Bayer Healthcare Llc, Consumer Care.

Event Text Entries

[93029209] This spontaneous case was reported by a consumer and describes the occurrence of medical device site injury ("it causse mt planta fascie to rupture caused me to have surgery") in a male patient who received dr scholls custom fit orthotic inserts 430 for pain and discomfort. On an unknown date, the patient started dr scholls custom fit orthotic inserts 430. On an unknown date, the patient experienced medical device site injury (seriousness criteria medically significant and intervention required). The patient was treated with surgery. It was unknown whether any action was taken with dr scholls custom fit orthotic inserts 430. At the time of the report, the medical device site injury outcome was unknown. The reporter considered medical device site injury to be related to dr scholls custom fit orthotic inserts 430. Most recent follow-up information incorporated above includes: on (b)(6) 2017: suspect product was revised to dr scholls custom fit orthotic inserts 430 (instead of previously reported 410). Moreover, case was also considered serious due to intervention required. This spontaneous case was reported by a consumer and describes the occurrence of medical device site injury ("it causse mt planta fascie to rupture caused me to have surgery") in a male patient who received dr scholls custom fit orthotic inserts for pain and discomfort. The reported event is serious due to medical significance, required intervention and is unlisted in the reference safety information of dr scholls custom fit orthotic inserts. Considering the implied temporal association and the fact, that the suspect device may have an effect on the plantar fascia due to close spatial proximity and arch support, company conservatively considers the causality to be related. It is important to note, that such a rupture is more likely to occur in patient's with chronic plantar fasciitis and/or diabetes, overweight or recipients of corticosteroid therapy. In this case no information was reported on risk factors. This case was regarded as incident.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2248903-2017-00001
MDR Report Key7060847
Report SourceCONSUMER,OTHER
Date Received2017-11-27
Date of Report2018-01-11
Date Mfgr Received2017-12-13
Date Added to Maude2017-11-27
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 ContactK SHAW LAMBERSON
Manufacturer Street100 BAYER BLVD. P.O. BOX 915
Manufacturer CityWHIPPANY NJ 079810915
Manufacturer CountryUS
Manufacturer Postal079810915
Manufacturer G1BAYER HEALTHCARE LLC, CONSUMER CARE
Manufacturer Street36 COLUMBIA ROAD
Manufacturer CityMORRISTOWN NJ 07960
Manufacturer CountryUS
Manufacturer Postal Code07960
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameDR SCHOLLS
Generic NameORTHOSIS, CORRECTIVE SHOE
Product CodeKNP
Date Received2017-11-27
OperatorLAY USER/PATIENT
Device Availability*
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerBAYER HEALTHCARE LLC, CONSUMER CARE
Manufacturer Address36 COLUMBIA ROAD MORRISTOWN NJ 07960 US 07960


Patients

Patient NumberTreatmentOutcomeDate
101. Other; 2. Required No Informationntervention 2017-11-27

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