MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,user facility report with the FDA on 2020-01-24 for FETAL SPIRAL ELECTRODE 989803137631 manufactured by Philips Medical Systems.
[180896611]
Serial number unknown. A follow-up report will be submitted once the investigation is complete.
Patient Sequence No: 1, Text Type: N, H10
[180896612]
The customer reported after removing the scalp electrode the spiral tip was not visible on the electrode anymore. It was broken, but was not found in the skin of the baby. After a few days at home, the midwife found the tip in the skin of the baby.
Patient Sequence No: 1, Text Type: D, B5
[186261579]
The fetal scalp electrode fragment was removed from the infant? S scalp and no further details of the infant? S condition were provided. The fetal scalp electrode was discarded and not returned for analysis. The cause of the broken electrode could not be determined.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 1218950-2020-00566 |
| MDR Report Key | 9628277 |
| Report Source | FOREIGN,USER FACILITY |
| Date Received | 2020-01-24 |
| Date of Report | 2020-01-23 |
| Date of Event | 2020-01-13 |
| Date Mfgr Received | 2020-01-23 |
| Date Added to Maude | 2020-01-24 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MR. ROBERT CORNING |
| Manufacturer Street | 3000 MINUTEMAN ROAD |
| Manufacturer City | ANDOVER MA 01810 |
| Manufacturer Country | US |
| Manufacturer Postal | 01810 |
| Manufacturer Phone | 9786871501 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | FETAL SPIRAL ELECTRODE |
| Generic Name | FETAL SPIRAL ELECTRODE, SINGLE |
| Product Code | HGP |
| Date Received | 2020-01-24 |
| Model Number | 989803137631 |
| Catalog Number | 989803137631 |
| Lot Number | UNKNOWN |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | PHILIPS MEDICAL SYSTEMS |
| Manufacturer Address | 3000 MINUTEMAN ROAD ANDOVER MA 01810 US 01810 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2020-01-24 |