FDA Adverse Event Injury Summary report: N

TOURNI-COT - UNIVERSAL

MDR report key: 10795761 · Received November 5, 2020

Report

Report Number
1832653-2020-00001
Event Type
Injury
Date Received
November 5, 2020
Date of Event
July 1, 2020
Report Date
October 2, 2020
Manufacturer
MAR-MED INC.
Product Code
GAX
UDI-DI
00855364004085
PMA / PMN Number
K853472
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 1

WE RECEIVED A REPORT FROM THE USER INDICATING THE PROBLEMS THEY EXPERIENCED. THEY REPORTED THERE WAS A DEVICE FAILURE AND ASSOCIATED USER ERROR. WE ARE CURRENTLY IN THE PROCESS OF REVIEWING OUR INTERNAL SYSTEMS TO SEE HOW TO ADDRESS THIS EVENT.

Description of Event or Problem · 1

FINGER TOURNIQUET WAS LEFT INSITU FOLLOWING LOCAL ANAESTHETIC PROCEDURE. IT IS UNKNOWN WHETHER IT WAS PART OR THE WHOLE DEVICE. DETAILS OF INJURY (TO PATIENT, CARER OR HEALTHCARE PROFESSIONAL): THE (B)(6) YEAR OLD PATIENT'S FINGER HAD DRY GANGRENE WHICH HAD TO BE AMPUTATED. ACTION TAKEN (INCLUDES ANY ACTION BY PATIENT, CARER OR HEALTHCARE PROFESSIONAL, OR BY THE MANUFACTURER OR SUPPLIER) DEVICE REMOVED FROM USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1255083 TOURNI-COT - UNIVERSAL TOURNI-COT - UNIVERSAL GAX MAR-MED INC. TCU 121909-A 00855364004085

Patients

Seq Age Sex Outcome Treatment
1 14 YR Disability