FDA Adverse Event
Malfunction
Summary report: N
FISHER WALLACE CRANIAL NEUROSTIMULATOR
MDR report key: 16862010
·
Received May 3, 2023
Report
- Report Number
- 3006258094-2023-00041
- Event Type
- Malfunction
- Date Received
- May 3, 2023
- Report Date
- February 2, 2023
- Manufacturer
- FISHER WALLACE LABS
- Product Code
- QJQ
- PMA / PMN Number
- K903654
- Removal / Correction Number
- RES 91982
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NY, US
- Reporter Occupation
- 003
Narratives
Description of Event or Problem · 0
HELLO, I SENT OUT AN EMAIL LAST WEEK REGARDING THE PADS REPLACEMENT. THANK YOU FOR THE NEW ONES. I'M HAVING ISSUES WITH THE CONTROL. I REPLACED THE BATTERIES AND IT HEATED UP, AND IT SMELLED LIKE BURNING PLASTIC SO I REMOVED THE BATTERY AGAIN. CAN THE CONTROL BE REPLACED TOO?
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 811244 | FISHER WALLACE CRANIAL NEUROSTIMULATOR | CRANIAL NEUROSTIMULATOR | QJQ | FISHER WALLACE LABS | FW-100 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Female | Other |