MAUDE MDR 8446464

MDR report key
8446464
Report number
2020362-2019-00049
Event key
0
Event type
3
Date of event
2019-02-24
Date received
2019-03-22
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
WILLIAM HINCY
Address
POSEY COMPANY 5635 PECK ROAD ARCADIA CA 91006 US
Phone
626-626-6264
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1CONNECTED TWICE-AS-TOUGH CUFFSRESTRAINT, PROTECTIVEPOSEY PRODUCTS LLCFMQ27942794R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-03-220

Event Narratives#

N

Patient 1

CUSTOMER CONFIRMED THE PRODUCT WAS DISCARDED AND THEY WILL NOT BE RETURNING. THEREFORE, THIS COMPLAINT IS BASED SOLELY ON THE CUSTOMER REPORTED ISSUE. ADDITIONAL CUSTOMER FEEDBACK IS CURRENTLY PENDING. AT THIS TIME THERE IS NO EVIDENCE THAT A MANUFACTURING NON-CONFORMITY CONTRIBUTED TO THE REPORTED COMPLAINT, AND THE INSTRUCTIONS FOR USE WERE REVIEWED AND DETERMINED TO PROVIDE ADEQUATE INSTRUCTIONS AND WARNINGS FOR THE SAFE AND EFFECTIVE USE OF THE DEVICE. INSTRUCTIONS FOR USE INDICATE; NOT TO USE THIS DEVICE ON A PATIENT WHO IS OR BECOMES; HIGHLY AGGRESSIVE OR COMBATIVE; SELF-DESTRUCTIVE; OR DEEMED TO BE AN IMMEDIATE RISK TO OTHERS, UNLESS THE PATIENT IS UNDER CONSTANT SUPERVISION. INSTRUCTIONS FOR USE ALSO INDICATE; SEVERE PSYCHOLOGICAL, OR PHYSICAL PROBLEMS MAY OCCUR: IF THE APPLIED DEVICE IS UNCOMFORTABLE; OR IF IT SEVERELY LIMITS MOVEMENT. IF THE PATIENT IS LIKELY TO CAUSE INJURY TO HIM/HERSELF OR OTHERS, GET HELP FROM A QUALIFIED MEDICAL AUTHORITY TO FIND ALTERNATE INTERVENTION OR METHOD OF RESTRAINT. THEREFORE, NO CORRECTIVE OR PREVENTATIVE ACTIONS ARE NECESSARY. ALL COMPLAINTS ARE TRENDED AND REVIEWED BY MANAGEMENT ON A MONTHLY BASIS. AS PART OF THIS MONTHLY REVIEW, ANY EXCURSION ABOVE THE CONTROL LIMITS FOR THIS FAILURE MODE WILL BE ASSESSED, DOCUMENTED AND ACTED UPON AS WARRANTED. MANUFACTURER REFERENCE FILE #(B)(4). PRODUCT WAS DISCARDED.

D

Patient 1

CUSTOMER REPORTED AN ADOLESCENT PATIENT SOMEHOW GOT HER ARMS BEHIND HER BACK AND ABOVE HER HEAD. THE NURSE ATTEMPTED TO REAPPLY THE RESTRAINT AND A SPRING ON THE LOCK BROKE FREE AND WOULD NOT RE-LOCK. THE PATIENT WAS NOT INJURED BUT THE NURSE WAS INJURED. THE EXTENT OF THE NURSE'S INJURY IS CURRENTLY UNKNOWN.