FDA Adverse Event Other Summary report: N

ELECTRODE PAD, SPLIT

MDR report key: 1190864 · Received October 6, 2008

Report

Report Number
1643264-2008-00018
Event Type
Other
Date Received
October 6, 2008
Date of Event
August 28, 2008
Report Date
September 5, 2008
Manufacturer
SMITH & NEPHEW INC., ENDOSCOPY DIV.
Product Code
ODR
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

NO PRODUCT IS BEING RETURNED FOR EVALUATION.

Description of Event or Problem · 1

A VALLEY LAB SPLIT PAD WAS PLACED ON THE THIGH OF THE OPERATIVE SIDE OF THE PATIENT. AFTER THE CASE, WHEN PAD WAS REMOVED THERE WAS A 1" ROUND BURN ON THE THIGH. NO OTHER INFORMATION IS AVAILABLE FOR THIS INCIDENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ELECTRODE PAD, SPLIT GROUND PAD ODR SMITH & NEPHEW INC., ENDOSCOPY DIV. 7209687

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention