ALEVE TENS DEVICE DIRECT THERAPY UNIT 1613538

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,other report with the FDA on 2018-10-26 for ALEVE TENS DEVICE DIRECT THERAPY UNIT 1613538 manufactured by Bayer Healthcare Llc, Consumer Care.

Event Text Entries

[125096381] This spontaneous case was reported by a lawyer and describes the occurrence of medical device site burn ("horrible burns/skin got burned at the application site") in a (b)(6)year-old female patient who received aleve tens device direct therapy unit for sciatica. Other product or product use issues identified: device use issue "aleve tens used for sciatica pain" on (b)(6) 2018 and device malfunction "device malfunction". Medical conditions: no concomitant drugs. On an unknown date, the patient started aleve tens device direct therapy unit. On (b)(6) 2018, the patient experienced medical device site burn (seriousness criterion medically significant) with medical device site erythema and medical device site pain. The patient was treated with naproxen sodium (aleve caplet). At the time of the report, the medical device site burn had not resolved. The reporter considered medical device site burn to be related to aleve tens device direct therapy unit. The reporter commented: sciatica pain diagnosed in (b)(6) 2018. It was the first time patient used the aleve tens. Patient carefully read the instructions. Device purchased on (b)(6) 2018 and used on the same day (30 minutes cycle during the night). While she was in the shower in the morning on (b)(6) 2018, she noticed the areas where the gel pad was being sensitive. Later on when she looked at the mirror she noticed that it was red and burned. According to patient no excessive or unusual device output noticed during treatment, no lubricant or foreign substances or cleaning agents used on the gel pad and device was not damaged. Gel pads lot number and expiration date unknown. Diagnostic results (normal ranges are provided in parenthesis if available): body mass index was 20. 7 kg/sqm. Most recent follow-up information incorporated above includes: on(b)(6) 2018: this case became potential legal case and device malfunction was added as event. This (b)(6)-year-old female patient used aleve tens device direct therapy unit for sciatica pain and experienced medical device site burn. The event is unlisted in reference safety information for suspect product. Considering probable temporal relationship, relation of the site of application and the electric nature of this device, company cannot exclude causality of suspect product. This case was regarded as incident.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2248903-2018-00005
MDR Report Key8008538
Report SourceCONSUMER,OTHER
Date Received2018-10-26
Date of Report2018-11-14
Date of Event2018-08-02
Date Mfgr Received2018-11-09
Date Added to Maude2018-10-26
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 ContactK LAMBERSON
Manufacturer Street100 BAYER BLVD. P.O. BOX 915
Manufacturer CityWHIPPANY NJ 079810915
Manufacturer CountryUS
Manufacturer Postal079810915
Manufacturer G1BAYER HEALTHCARE LLC, CONSUMER CARE
Manufacturer Street36 COLUMBIA RD
Manufacturer CityMORRISTOWN NJ 07960
Manufacturer CountryUS
Manufacturer Postal Code07960
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameALEVE TENS DEVICE DIRECT THERAPY UNIT
Generic NameSTIMULATOR, NERVE, TRANSCUTANEOUS, ELECTRICAL NERVE STIMULATOR (TENS)
Product CodeNUH
Date Received2018-10-26
Returned To Mfg2018-08-20
Model Number1613538
Lot NumberT0K6M8
OperatorLAY USER/PATIENT
Device AvailabilityR
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerBAYER HEALTHCARE LLC, CONSUMER CARE
Manufacturer Address36 COLUMBIA RD. MORRISTOWN NJ 07960 US 07960


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2018-10-26

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