MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor report with the FDA on 2018-09-04 for UPG NV TO HEAD-SPINE 1.5T 9896-030-14892 manufactured by Carma Salud, S.l..
[119575052]
The investigation is still ongoing for this event. When the investigation is complete a follow-up report will be sent to the fda.
Patient Sequence No: 1, Text Type: N, H10
[119575053]
A patient was being scanned using the 1. 5t spine coil. The coil cable was placed over the patients leg and experienced a 3rd degree burn as a result. Blister appears to be approximately 3 cm in size.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1056069-2018-00005 |
| MDR Report Key | 7856798 |
| Report Source | DISTRIBUTOR |
| Date Received | 2018-09-04 |
| Date of Report | 2018-08-20 |
| Date of Event | 2018-08-13 |
| Date Mfgr Received | 2018-07-25 |
| Device Manufacturer Date | 2011-01-18 |
| Date Added to Maude | 2018-09-07 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 0 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MR. KENNETH REVENNAUGH |
| Manufacturer Street | C/ DISC |
| Manufacturer City | MADRID 28022 |
| Manufacturer Country | SP |
| Manufacturer Postal | 28022 |
| Manufacturer G1 | PHILIPS HEALTHCARE - INVIVO DIAGNOSTIC IMAGING |
| Manufacturer Street | 3545 SW 47TH AVE |
| Manufacturer City | GAINESVILLE FL 32608 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 32608 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | UPG NV TO HEAD-SPINE 1.5T |
| Generic Name | UPG NV TO HEAD-SPINE 1.5T |
| Product Code | MOS |
| Date Received | 2018-09-04 |
| Model Number | 9896-030-14892 |
| Lot Number | N/A |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | * |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | CARMA SALUD, S.L. |
| Manufacturer Address | C/ DISC?BOLO, 91-P4-2?A MADRID 28022 SP 28022 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2018-09-04 |