UL PRO FUSED HEADLIGHT CABLE 9FT, 275CM 001388LX9

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2018-12-19 for UL PRO FUSED HEADLIGHT CABLE 9FT, 275CM 001388LX9 manufactured by Integra York, Pa Inc..

Event Text Entries

[131488974] The device was not returned to the manufacturer for analysis. The plant investigation is in progress and a supplemental medwatch report will be submitted upon completion of the investigation.
Patient Sequence No: 1, Text Type: N, H10


[131488975] A customer reported to integra that on (b)(6) 2018, the 001388lx9 ul pro fused headlight cable 9ft, during an unspecified case, the quality of the light intensity diminished. The customer felt the light cord was burning out. Additional information was received on (b)(6) 2018 reporting that the product problem was discovered during inspection, and the lighting was not adequate for the surgeon. Device was not used during a neuro procedure. There was a 30-minute surgical delay due to the product problem, however there was no patient adverse consequence. The action that was taken after the product problem occurred was that the surgeon decided not to use the headlight.
Patient Sequence No: 1, Text Type: D, B5


[132630212] The product was not sent in to the manufacturer for evaluation. No failure analysis and determination of root cause could be determined. The complaint could not be verified given that a product sample was not returned to verify the complaint. Udi # (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[132630213] N/a.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2523190-2018-00182
MDR Report Key8181204
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2018-12-19
Date of Report2018-12-03
Date of Event2018-11-23
Date Mfgr Received2018-12-28
Date Added to Maude2018-12-19
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 ContactUSER KIMBERLY SHELLY
Manufacturer Street311 ENTERPRISE DRIVE
Manufacturer CityPLAINSBORO NJ 08536
Manufacturer CountryUS
Manufacturer Postal08536
Manufacturer Phone6099362393
Manufacturer G1INTEGRA YORK, PA INC.
Manufacturer Street589 DAVIES DRIVE
Manufacturer CityYORK PA 17402
Manufacturer CountryUS
Manufacturer Postal Code17402
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUL PRO FUSED HEADLIGHT CABLE 9FT, 275CM
Generic NameCABLES
Product CodeFST
Date Received2018-12-19
Catalog Number001388LX9
Lot Number9951917
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerINTEGRA YORK, PA INC.
Manufacturer Address589 DAVIES DRIVE 589 DAVIES DRIVE YORK PA 17402 US 17402


Patients

Patient NumberTreatmentOutcomeDate
10 2018-12-19

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