BIS 186-0106

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2018-04-25 for BIS 186-0106 manufactured by Aspect Medical.

Event Text Entries

[106621718] If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


[106621719] According to the reporter, prior to use, a reading or impedance check issue occurred, the device's electrode number 2 had a high reading at sensor check. It was reported that the forehead was cleaned using an alcohol swab. It was indicated that there was patient injury.
Patient Sequence No: 1, Text Type: D, B5


[117306387] If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


[117306388] According to the reporter, during use, a reading or impedance check issue occurred, the device's electrode number 2 had a high reading at sensor check. It was reported that the forehead was cleaned using a alcohol swab. It was indicated that there was no patient injury.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2936999-2018-00297
MDR Report Key7458370
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2018-04-25
Date of Report2018-08-15
Date of Event2018-02-05
Date Mfgr Received2018-07-26
Date Added to Maude2018-04-25
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 ContactAVI KLUGER
Manufacturer Street15 HAMPSHIRE ST.
Manufacturer CityMANSFIELD MA 02048
Manufacturer CountryUS
Manufacturer Postal02048
Manufacturer Phone3035306582
Manufacturer G1ASPECT MEDICAL
Manufacturer Street1 UPLAND RD
Manufacturer CityNORWOOD MA 02062
Manufacturer CountryUS
Manufacturer Postal Code02062
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameBIS
Generic NameELECTRODE, CUTANEOUS
Product CodeGXY
Date Received2018-04-25
Returned To Mfg2018-07-24
Model Number186-0106
Catalog Number186-0106
Lot Number186-0106
Device Expiration Date2015-11-30
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerASPECT MEDICAL
Manufacturer Address1 UPLAND RD NORWOOD MA 02062 US 02062


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2018-04-25

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