MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2018-01-03 for DEROYAL 1143PP manufactured by Ortho And Surgical Products Enterprises S.a..
[96209719]
A call/complaint was received indicating that the "binder was applied post op directly next to skin patient broke out in rash". It was reported that the sample was not available for return. The process records have been checked and no issues were found related to the problem reported. Eighty each abdominal binders were inspected from work in process and no issues were found during the inspection. The root cause was unable to be determined, possible patient sensitivity. The abdominal binder is made of polyester, nylon and lycra spandex and is not made with natural rubber latex. There have been no other complaints reported for this finished good product number. Between, december 16, 2015 - december 18, 2017, there has been one report of this malfunction for a percentage of (b)(4), of this product (b)(4) abdominal binder. No further information is available at this time. We will provide a follow up report if additional information becomes available.
Patient Sequence No: 1, Text Type: N, H10
[96209720]
Quality issue details: date of occurrence: (b)(6) 2017. When did quality issue occur? During use. Who was using or operating the product when the quality issue occurred? Patient/end consumer. Was a medical procedure involved? Yes. Name of medical procedure: c-section. Did the quality issue cause a delay in the medical procedure? No (please provide length of delay and any other details about the procedure in the detailed description field below). Detailed description of quality issue: binder was applied post op directly next to skin patient broke out in rash. How was the quality issue was identified? By actual use. How was the product being used? Post op c-section. Was it the initial use of the product? Yes. Was the product modified from the original condition supplied by deroyal? No. Was the product connected to or used in conjunction with other devices or equipment? No. Outcome details: outcome(s) attributed to quality issue: irritation, reaction, rash. Details of irritation, reaction, rash (severity, medical treatment, etc. ): no info provided. Person(s) affected by outcome(s) checked above: patient. Known pre-existing condition(s) of person(s) affected: none specified. Was the incident reported to the fda? No. Detailed description of outcome(s), including information regarding injury or any additional treatment/intervention required: customer reported to s2s no injury other than rash reported.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3010452421-2017-00007 |
| MDR Report Key | 7159568 |
| Report Source | CONSUMER |
| Date Received | 2018-01-03 |
| Date of Report | 2017-12-08 |
| Date of Event | 2017-12-08 |
| Date Added to Maude | 2018-01-03 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 0 |
| Initial Report to FDA | 0 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS. MELISSA LOGSDON |
| Manufacturer Street | 200 DEBUSK LANE |
| Manufacturer City | POWELL TN 37849 |
| Manufacturer Country | US |
| Manufacturer Postal | 37849 |
| Manufacturer Phone | 8653626157 |
| Manufacturer G1 | ORTHO AND SURGICAL PRODUCTS ENTERPRISES S.A. |
| Manufacturer Street | KM 20.5 CARRETERA A VILLA CANALES |
| Manufacturer City | VILLA CANALES, GUATEMALA 01065 |
| Manufacturer Country | GT |
| Manufacturer Postal Code | 01065 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | DEROYAL |
| Generic Name | ABDOMINAL BINDER |
| Product Code | FSD |
| Date Received | 2018-01-03 |
| Model Number | 1143PP |
| Device Availability | N |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ORTHO AND SURGICAL PRODUCTS ENTERPRISES S.A. |
| Manufacturer Address | KM 20.5 CARRETERA A VILLA CANALES VILLA CANALES, GUATEMALA 01065 GT 01065 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2018-01-03 |