MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a user facility report with the FDA on 2020-02-05 for ZIO XT PATCH N100A102X manufactured by Irhythm Technologies, Inc.
[177805698]
At the conclusion of the investigation, the reported event was confirmed. The probable cause is likely due to a user error that occurred while registering the device to the appropriate patient during the device application process.
Patient Sequence No: 1, Text Type: N, H10
[177805699]
It was reported that two patient's devices were swapped during the patient registration process by the healthcare provider. As a result, an incorrect ecg report provided to the physician resulted in treatment to the incorrect patient.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3007208829-2020-00002 |
| MDR Report Key | 9670989 |
| Report Source | USER FACILITY |
| Date Received | 2020-02-05 |
| Date of Report | 2019-10-11 |
| Date of Event | 2019-10-02 |
| Date Mfgr Received | 2019-10-11 |
| Device Manufacturer Date | 2019-08-28 |
| Date Added to Maude | 2020-02-05 |
| 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 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MR. RICH LAGUNA |
| Manufacturer Street | 699 8TH ST SUITE 600 |
| Manufacturer City | SAN FRANCISCO CA 94103 |
| Manufacturer Country | US |
| Manufacturer Postal | 94103 |
| Manufacturer Phone | 4156325749 |
| Manufacturer G1 | IRHYTHM TECH, INC |
| Manufacturer Street | 11085 KNOTT AVENUE SUITE B |
| Manufacturer City | CYPRESS CA 90630 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 90630 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ZIO XT PATCH |
| Generic Name | ZIO PATCH |
| Product Code | DSH |
| Date Received | 2020-02-05 |
| Model Number | N100A102X |
| Device Expiration Date | 2020-02-24 |
| Operator | LAY USER/PATIENT |
| Device Availability | * |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | IRHYTHM TECHNOLOGIES, INC |
| Manufacturer Address | 699 8TH ST SUITE 600 SAN FRANCISCO CA 94103 US 94103 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2020-02-05 |