MAUDE MDR 756492

MDR report key
756492
Report number
1423507-2006-00100
Event key
0
Event type
3
Date of event
2006-06-14
Date received
2006-08-30
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
MICHELE DONATICH
Address
1430 WAUKEGAN RD BLDG KB MCRAW PARK IL 60085 US
Phone
847-847-8475
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1UNKNOWN COLD PACKUNKNOWN COLD PACKCARDINAL HEALTHKYRUNKCOLDPKUNCOLDPKUNKNRN

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12006-08-3001. O

Event Narratives#

D

Patient 1

SHE SAID, SHE HAD RECEIVED THE GEL PACK FROM SOMEONE ELSE. SHE SAID, THE PACK WAS FROZEN, AND SHE PLACED IT IN A TOWEL AND THEN PLACED IT ON HER BACK AND LAY DOWN. SHE SAID, THAT IS WAS ON HER BACK FOR LESS THAN 10 MINUTES AND SHE NOTICED IT WAS REALLY COLD, SO SHE TOOK IT OFF HER BACK. THAT IS WHEN SHE SAID THAT SHE NOTICED A BURN ON HER BACK. SHE WENT TO THE DOCTOR, AND SAID THAT BY THIS TIME, THERE WAS BLISTER FORMING AND THE BURNED AREA WAS 5 1/2"X6: IN DIAMETER.

N

Patient 1

AS NO SAMPLES WERE PROVIDED TO DATE, THE EXACT CAUSE OF THE DIFFICULTIES ENCOUNTERED CANNOT BE DETERMINED. IN ADDITION, NO LOT NUMBER WAS REPORTED, SO THE DEVICE HISTORY RECORD COULD NOT BE REVIEWED. UNDER ROUTING PRODUCTION, A SAMPLING OF THESE UNITS IS TESTED FOR POUCH INTEGRITY AND THE PRODUCTION RUN IS NOT RELEASED UNTIL ALL ASPECTS OF PRODUCT QUALITY MEET PRODUCT SPECIFICATIONS. ALTHOUGH GREAT EFFORT IS TAKEN IN ENSURING THAT ALL FUNCTION AS DESIGNED, AT TIMES, ONE MAY FAIL TO MEET PERFORMANCE EXPECTATIONS FOR A CERTAIN REASON. IN THOSE INSTANCES, IT IS VITAL TO THE INVESTIGATION THAT THE PRODUCT SAMPLE BE AVAILABLE FOR EXAMINATION AND TESTING IN ORDER TO DETERMINE THE ROOT CAUSE. UNFORTUNATELY, IN THIS SITUATION THAT IS NOT THE CASE. WE WILL CONTINUE TO MONITOR FOR OTHER SIMILAR COMPLAINTS AND UTILIZE THE INFORMATION AS PART OF CONTINUOUS IMPROVEMENT.