ERGOJUST CART 024779 N/A

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-11-15 for ERGOJUST CART 024779 N/A manufactured by Natus Medical Inc. Dba Excle-tech Ltd (xltek).

Event Text Entries

[127365750] Following natus complaint procedure, natus performed the investigation. It was concluded that customer failed to follow the installtion instruction provided with the bracket kit. The bracket kit was installed properly however screw that tightens the bracket was incorrectly inseted and missed the t-nut slot which resulted in a lossening the screws. Natus field service employee sent onsite to install the bracket correctly.
Patient Sequence No: 1, Text Type: N, H10


[127365751] New ergojust bracket is coming loose and a screw was missing. Natus fields service employee was on site on oct 25th to inspect the bracket installation and observed that 1 screw was missing and other 3 screws were loose.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9612330-2018-00017
MDR Report Key8074429
Date Received2018-11-15
Date of Report2018-10-25
Date of Event2018-10-02
Date Mfgr Received2018-10-25
Date Added to Maude2018-11-15
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR SANJAY MEHTA
Manufacturer Street2568 BRISTOL CIRCLE
Manufacturer CityOAKVILLE, ONTARIO L6H5S1
Manufacturer CountryCA
Manufacturer PostalL6H5S1
Manufacturer G1NATUS MEDICAL INCORPORATED DBA EXCEL-TECH (XLTEK)
Manufacturer Street2568 BRISTOL CIRCLE
Manufacturer CityOAKVILLE, ONTARIO L6H5S1
Manufacturer CountryCA
Manufacturer Postal CodeL6H5S1
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameERGOJUST CART
Generic NameELECTROENCEPHALOGRAPH
Product CodeGWQ
Date Received2018-11-15
Model Number024779
Catalog NumberN/A
Lot NumberN/A
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerNATUS MEDICAL INC. DBA EXCLE-TECH LTD (XLTEK)
Manufacturer Address2568 BRISTOL CIRCLE OAKVILLE, OAKVILLE ONTARIO L6H 5S1 CA L6H 5S1


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2018-11-15

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