FDA Adverse Event Injury Summary report: N

LOCALIZER

MDR report key: 11942584 · Received June 4, 2021

Report

Report Number
3013649990-2021-00005
Event Type
Injury
Date Received
June 4, 2021
Date of Event
May 6, 2021
Report Date
May 7, 2021
Manufacturer
HEALTH BEACONS INC.
Product Code
NEU
PMA / PMN Number
K193189
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
003

Narratives

Description of Event or Problem · 1

ON (B)(6) 2021 , THE LOCALIZER TAG WAS IMPLANTED IN PATIENT. 15 MINUTES AFTER IMPLANTATION, THE PATIENT EXPERIENCED AN ALLERGIC REACTION. THE PATIENT HAS KNOWN ALLERGIES TO TAPE ADHESIVE, LATEX, ALUM AND PENICILLIN. THE ALLERGIC REACTION APPEARED AS A RASH ON THE PATIENT'S BACK; IT WAS NOT LOCAL TO THE IMPLANTATION AREA. IT WAS LEARNED THAT THIS PATIENT HAD ALSO EXPERIENCED AN ALLERGIC REACTION TO THE PLACEMENT OF A NON-HEALTH BEACONS MARKER SEVERAL DAYS EARLIER. ON (B)(6) 2021 HEALTH BEACONS/HOLOGIC REACHED OUT TO THE RADIOLOGIST TO INQUIRE IF THE USE OF LIDOCAINE COULD HAVE POSSIBLY CAUSED THE PATIENT'S ALLERGIC REACTIONS, SINCE IT WAS INJECTED PRIOR TO THE PROCEDURE. THE RADIOLOGIST'S OPINION WAS THAT THE REACTION WAS NOT DUE TO THE LIDOCAINE USED, AS THE PATIENT HAD MENTIONED THAT SHE HAD RECEIVED LIDOCAINE BEFORE AT THE DENTIST, WITH NO ISSUES. IT WAS REPORTED THAT THE RASH RESOLVED ITSELF WITHOUT INTERVENTION. HEALTH BEACONS ATTEMPTED TO OBTAIN ADDITIONAL INFORMATION RELATED TO THE REMOVAL OF THE TAG AND THE INTEGRITY OF THE TAG AFTER IMPLANTATION, BUT MULTIPLE ATTEMPTS TO OBTAIN THIS INFORMATION WERE UNSUCCESSFUL. THERE IS NO ADDITIONAL INFORMATION ABOUT THE TAG AND ITS REMOVAL AVAILABLE FOR THE INVESTIGATION. GIVEN THAT THE RASH RESOLVED ITSELF WITHOUT INTERVENTION AND THAT THE PATIENT EXPERIENCED A SIMILAR REACTION TO AN UNRELATED PRODUCT IN THE DAYS PRIOR TO THIS EVENT, HEALTH BEACONS HAS CONCLUDED THAT IT IS VERY UNLIKELY THAT THE RASH IS RELATED TO THE TAG OR THE TAG APPLICATOR MATERIALS, WHICH HAVE BEEN TESTED FOR BIOCOMPATIBILITY. NO OTHER COMPLAINTS OF THIS TYPE HAVE BEEN RECEIVED OVER THE SPAN OF MORE THAN 50,000 TAG IMPLANTATIONS IN THREE YEARS. THIS EVENT IS BEING REPORTED OUT OF AN ABUNDANCE OF CAUTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
836778 LOCALIZER TAG APPLICATOR NEU HEALTH BEACONS INC. HB205-10 46517

Patients

Seq Age Sex Outcome Treatment
1 Other