PROCARE ONE-PIECE CERVICAL COLLAR 79-83131

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-05-17 for PROCARE ONE-PIECE CERVICAL COLLAR 79-83131 manufactured by Djo, Llc.

Event Text Entries

[145615396] On multiple occasions, the product (procare black one-piece cervical collar - 79-83131) broke while it was being sized / applied to the pt while being used / applied in accordance with mfr's instructions. Generally, the break occurs in the area where the collar fits under the chin (grey plastic in pictures). At one time, a small piece of hard plastic broke off. Flew through the air, and just narrowly missed hitting someone in the face. People applying this collar seem to experience a >50% failure / breakage rate. Fda safety report id# (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5086721
MDR Report Key8623742
Date Received2019-05-17
Date of Report2019-05-16
Date of Event2019-05-14
Date Added to Maude2019-05-20
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
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
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NamePROCARE ONE-PIECE CERVICAL COLLAR
Generic NameORTHOSIS, CERVICAL
Product CodeIQK
Date Received2019-05-17
Catalog Number79-83131
Device AvailabilityN
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerDJO, LLC


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2019-05-17

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