FDA Adverse Event Malfunction Summary report: N

INTELECT MOBILE 2CH STIM

MDR report key: 1180922 · Received September 29, 2008

Report

Report Number
1022819-2008-00233
Event Type
Malfunction
Date Received
September 29, 2008
Date of Event
August 10, 2006
Report Date
August 10, 2006
Manufacturer
CHATTANOOGA GROUP
Product Code
IPF
Removal / Correction Number
1022819-11/15/2007-001-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS DEVICE IS FOR EXPORT ONLY.

Description of Event or Problem · 1

PATIENT FELT SURGE AND SHOCK DURING IFC ELECTROTHERAPY TREATMENT AT 0.1MA. THIS MALFUNCTION CAUSES THE PRINTED CIRCUIT BOARD TO CHANGE THE STIMULATORY PATIENT OUTPUT FROM THE INTENDED OUTPUT TO AN UNINTENDED HIGHER VOLTAGE OUTPUT. WHEN SUCH A MALFUNCTION OCCURS, IT RESULTS IN A SHOCK SENSATION AND POSSIBLE BURN TO THE AREA BENEATH THE ELECTRODE PADS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INTELECT MOBILE 2CH STIM IPF, GZJ, GZI IPF CHATTANOOGA GROUP 2777

Patients

Seq Age Sex Outcome Treatment
1