FDA Adverse Event
Malfunction
Summary report: N
INTELECT MOBILE 2CH STIM
MDR report key: 1180929
·
Received September 29, 2008
Report
- Report Number
- 1022819-2008-00240
- Event Type
- Malfunction
- Date Received
- September 29, 2008
- Date of Event
- May 29, 2007
- Report Date
- May 29, 2007
- Manufacturer
- CHATTANOOGA GROUP
- Product Code
- IPF
- Removal / Correction Number
- 1022819-11/15/2007-001-C
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TU
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
THIS DEVICE IS FOR EXPORT ONLY.
Description of Event or Problem · 1
PRODUCT WAS REPORTED TO BE PRODUCING HIGH STIMULATION OUTPUT. THIS MALFUNCTION CAUSES THE PRINTED CIRCUIT BOARD TO CHANGE THE STIMULATORY PT 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.
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 |