TECA ELITE NEEDLE S53153

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2018-09-21 for TECA ELITE NEEDLE S53153 manufactured by Natus Manufacturing Ltd..

Event Text Entries

[121715427] Work order (b)(4) was reviewed. (b)(4) was referenced in relation to humidity failure in the cleanroom. In process testing and inspections recorded on doc-011247 rev g all gave pass results. The results for hub to cover retention test were within specification which is minimum 1. 2kgf. Lowest value recorded was 2. 490kgf, highest recorded value was 9. 235kgf. No reworks carried out on this lot. Defect product has been requested to be returned. Justification for not providing below information and applicable sections: patient information - no patient injury reported, device malfunction occurred. Date of event - date of event requested from the customer but information not yet provided relevant tests / laboratory data - this section is not applicable as no patient injury occurred. Other relevant history, including preexisting medical conditions: this section is not applicable as no patient injury occurred. Suspect products - not applicable. Serial # - this section is not applicable as the medical device does not have a serial number. If implanted date (mm/dd/yyyy) - this section is not applicable as the medical device is not implantable. If explanted date (mm/dd/yyyy) - this section is not applicable as the medical device is not implantable. Reprocessor name and address - this section is not applicable as the medical device is not a single-use device that was reprocessed or reused on a patient. Concomitant medical products and therapy dates (excluding treatment of event) - this section is not applicable to this type of device for use by user facility / importer - not applicable as we are not a facility or importer of device. If nd, give protocol # - this section is not applicable as the medical device is not ind. Adverse event terms - this section is not applicable to medical devices. If remedial action initiated , check type - this section is not applicable as no remedial action was initiated. If action reported to fda under 21 usc 360i (f), list correction / removal reporting number - this section is not applicable as there was no action reported under 21 usc 360i(f).
Patient Sequence No: 1, Text Type: N, H10


[121715428] Teca concentric needle hub to colour separation. Teca concentric s53153 (1 box), red casing around the needle is coming off on every single needle on this box.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3005581270-2018-00011
MDR Report Key7897219
Report SourceHEALTH PROFESSIONAL
Date Received2018-09-21
Date of Report2018-11-15
Date of Event2018-08-28
Date Mfgr Received2018-08-22
Device Manufacturer Date2018-03-14
Date Added to Maude2018-09-21
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 ContactMISS LOUISE CALLANAN
Manufacturer StreetIDA BUSINESS PARK GORT
Manufacturer CityGALWAY, CONNAUGHT H91PD92
Manufacturer CountryEI
Manufacturer PostalH91PD92
Manufacturer G1NATUS MANUFACTURING LTD
Manufacturer StreetIDA BUSINESS PARK GORT
Manufacturer CityGALWAY, CONNAUGHT H91PD92
Manufacturer CountryEI
Manufacturer Postal CodeH91PD92
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameTECA ELITE NEEDLE
Generic NameTECA ELITE DISPOSABLE CONCENTRIC NEEDLE ELECTRODE
Product CodeIKT
Date Received2018-09-21
Model NumberS53153
Catalog NumberS53153
Lot Number11B/18/T
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerNATUS MANUFACTURING LTD.
Manufacturer AddressIDA BUSINESS PARK GORT GALWAY, CONNAUGHT H91PD92 EI H91PD92


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2018-09-21

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