FDA Adverse Event Other Summary report: N

MIST THERAPY SYSTEM

MDR report key: 1369278 · Received April 21, 2009

Report

Report Number
3004580659-2009-00002
Event Type
Other
Date Received
April 21, 2009
Date of Event
March 6, 2009
Report Date
April 20, 2009
Manufacturer
CELLERATION, INC.
Product Code
NRB
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

COMPANY REPRESENTATIVE REVIEWED PROPER USE OF THE DEVICE AND ADHERENCE TO THE IFU WITH INDIVIDUAL INVOLVED IN THIS REPORT AS FOLLOW-UP TO THE INCIDENT.

Description of Event or Problem · 1

TREATMENT NURSE STATED SHE RECEIVED A SHOCK FROM THE TRANSDUCER WAND DURING A PATIENT TREATMENT. NURSE DESCRIBED THE SHOCK AS "AN INTENSE SENSATION" WHEN SHE TOUCHED THE TRANSDUCER TIP, AND FELT THE SENSATION ONLY AT THE POINT OF THE INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MIST THERAPY SYSTEM NONE NRB CELLERATION, INC. CP-80004

Patients

Seq Age Sex Outcome Treatment
1 Other