GEN IV PILLOW SPEAKER 4C331U-Z102798

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-10-02 for GEN IV PILLOW SPEAKER 4C331U-Z102798 manufactured by Curbell Medical Products Inc..

Event Text Entries

[122645059] User facility called curbell with an alleged patient burn that they believe was attributed to the curbell pillow speaker. The facility claimed that the pillow speaker became warm/hot and caused a patient burn. The severity of this burn is unknown and curbell tried repeatedly to gather this information. Curbell engineering tested the unit in question and was able to repeat the same situation and this is described in the description of this report. Curbell believes that the pillow speaker was subjected to an extreme mechanical impact in that it sheared a component (capacitor) that is mounted to the printed circuit board. However, there was no way to confirm that allegation.
Patient Sequence No: 1, Text Type: N, H10


[122645060] Curbell medical engineering conducted an analysis of the returned pillow speaker device. This unit was returned for an alleged thermal event where the volume buttons were excessively hot, around 154f as reported by the customer. Curbell medical engineering confirmed that everything in the unit was operating as expected, except the microphone for talkback. It was also observed that the volume buttons (or at least the area near these buttons) was hot to the touch. With the unit intact and unassembled, the unit was connected and at rest for 30 minutes. The temperature measured around the volume buttons peaked around 160f. The unit was then removed from service and opened for internal review. It was discovered the c15 capacitor (the 100uf line leveling output capacitor for the main 5v regulator) had its leads broken away from the main body of the capacitor, free of the printed circuit board, and was now able to move within the case enclosure. The heat source was generated by the 3. 3v regulator that takes its power from the 5v regulator. This 3. 3v regulator was removed and replaced and full functionality of the device was confirmed. Therefore, it is our belief that the device was exposed to an extreme mechanical impact significantly outside of the scope of normal operating conditions because the c15 capacitor did not have a cold solder joint (a cold solder joint is a weak comprised joint), but rather, the capacitor leads were physically severed from the main body of the capacitor component; thus allowing the main body component to move freely within the case enclosure. Moreover, the removal of c15 capacitor from the circuit made the 5v regulator extremely unstable which affected the 3. 3v regulator to the point where it became damaged. Consequently, this caused the source of heat to be produced. To date, (b)(4) gen iv pillow speaker devices have been sold and this is the only known occurrence of this type of incident. Finally, our pillow speaker devices have been validated to the ul 1069 standard which includes drop testing 100 cycles of the pillow speaker unit from a height of 4 feet onto a hard surface. Curbell medical pillow speakers have been successfully validated to this standard.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3000210521-2018-00001
MDR Report Key7925853
Date Received2018-10-02
Date of Report2018-10-02
Date of Event2018-09-07
Date Mfgr Received2018-09-07
Device Manufacturer Date2017-04-07
Date Added to Maude2018-10-02
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 ContactMR. MICHAEL WINTER
Manufacturer Street20 CENTRE DR.
Manufacturer CityORCHARD PARK NY 14127
Manufacturer CountryUS
Manufacturer Postal14127
Manufacturer Phone7166673377
Manufacturer G1CURBELL MEDICAL PRODUCTS INC.
Manufacturer Street20 CENTRE DR.
Manufacturer CityORCHARD PARK NY 14127
Manufacturer CountryUS
Manufacturer Postal Code14127
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameGEN IV PILLOW SPEAKER
Generic NamePILLOW SPEAKER
Product CodeILQ
Date Received2018-10-02
Returned To Mfg2018-09-12
Model Number4C331U-Z102798
Catalog Number4C331U-Z102798
Lot Number16142-0013
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerCURBELL MEDICAL PRODUCTS INC.
Manufacturer Address20 CENTRE DR. ORCHARD PARK NY 14127 US 14127


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2018-10-02

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