EP-WORKMATE? AND WORKMATE? CLARIS? EP-4? TOUCHSCREEN COMPUTER H21911

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 2019-05-06 for EP-WORKMATE? AND WORKMATE? CLARIS? EP-4? TOUCHSCREEN COMPUTER H21911 manufactured by St. Jude Medical, Inc..

Event Text Entries

[144144267] The results/method and conclusion codes along with investigation results will be provided in a subsequent submission.
Patient Sequence No: 1, Text Type: N, H10


[144144268] The touch screen interface was smoking from the back top right of the monitor prior to the procedure. The system had been on for about 15-20 minutes and all the sudden started smoking. It was unplugged from the power and bypassed directly to the workmate cpu and the case was completed with no further issues.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2184149-2019-00084
MDR Report Key8582516
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2019-05-06
Date of Report2019-05-20
Date of Event2019-04-22
Date Mfgr Received2019-05-07
Device Manufacturer Date2013-02-14
Date Added to Maude2019-05-06
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 ContactSTEPHANIE O' SULLIVAN
Manufacturer Street5050 NATHAN LANE NORTH
Manufacturer CityPLYMOUTH MN 55442
Manufacturer CountryUS
Manufacturer Postal55442
Manufacturer Phone6517565400
Manufacturer G1ST. JUDE MEDICAL, INC.
Manufacturer StreetONE ST. JUDE MEDICAL DRIVE
Manufacturer CityST. PAUL MN 55117
Manufacturer CountryUS
Manufacturer Postal Code55117
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Sequence Number: 0

Brand NameEP-WORKMATE? AND WORKMATE? CLARIS? EP-4? TOUCHSCREEN COMPUTER
Generic NameGENERATOR, PULSE, PACEMAKER, EXTERNAL PROGRAMMABLE
Product CodeDQK
Date Received2019-05-06
Model NumberH21911
Catalog NumberH21911
OperatorHEALTH PROFESSIONAL
Device Availability*
Device Eval'ed by MfgrR
Device Sequence No0
Device Event Key0
ManufacturerST. JUDE MEDICAL, INC.
Manufacturer AddressONE ST. JUDE MEDICAL DRIVE ST. PAUL MN 55117 US 55117

Device Sequence Number: 1

Brand NameEP-WORKMATE? AND WORKMATE? CLARIS? EP-4? TOUCHSCREEN COMPUTER
Generic NameGENERATOR, PULSE, PACEMAKER, EXTERNAL PROGRAMMABLE
Product CodeJOQ
Date Received2019-05-06
Model NumberH21911
Catalog NumberH21911
OperatorHEALTH PROFESSIONAL
Device Availability*
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerST. JUDE MEDICAL, INC.
Manufacturer AddressONE ST. JUDE MEDICAL DRIVE ST. PAUL MN 55117 US 55117


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2019-05-06

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