FDA Adverse Event Malfunction Summary report: N

IP-EC-VIDEO-EXT

MDR report key: 17554904 · Received August 16, 2023

Report

Report Number
9612330-2023-00024
Event Type
Malfunction
Date Received
August 16, 2023
Date of Event
July 31, 2023
Report Date
February 28, 2024
Manufacturer
NATUS MEDICAL INCORPORATED
Product Code
OMB
UDI-DI
00382830058377
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

FOLLOW UP REPORT 001 REF TO NATUS COMPLAINT#(B)(4). A REPLACEMENT PART WAS SENT TO ADDRESS THE ISSUE. TECHNICAL SERVICE HAVE REQUESTED THE CUSTOMER TO RETURN THE AFFECTED DEVICE FOR EVALUATION. TO DATE, THE DEVICE HAS NOT BEEN RETURNED. A REMINDER TO RETURN THE PRODUCT WAS SENT TO THE CUSTOMER (B)(6) 2023, (B)(6) 2023, AND THE (B)(6) 2023. NO RESPONSE TO DATE. ·

Additional Manufacturer Narrative · 0

FOLLOW UP REPORT 002 REF TO NATUS COMPLAINT#(B)(4). DEVICE WAS RETURNED ON 13-DEC-2023. INVESTIGATION RESULTS: ONE VIDEO EXTENSION WAS RETURNED WITH BOTH INNER WELDS BROKEN. ((B)(6)). THE TABS ON BOTH SIDES WERE BENT, AS WOULD HAPPEN IF THE WELDS BROKE AND THE TABS WERE SUPPORTING THE WEIGHT OF THE MAST. THE CUSTOMER NOTICED THAT THE MAST WAS WOBBLY AND CORRECTLY TOOK IT OUT OF SERVICE BEFORE THE MAST FELL. ROOT CAUSE/PROBABLE ROOT CAUSE: WELDS FAILED DUE TO UNKNOWN CAUSE, COULD BE MISUSE. RECOMMENDED ACTIONS: MONITOR FOR SIMILAR INCIDENTS, SECONDARY FEATURES WORKED AS DESIGNED TO PREVENT THE MAST FROM FALLING. IF MORE ISSUES ARE SEEN WITH THE QUALITY OF THE WELDS DISCUSS WITH THE SUPPLIER OF THE MAST. INVESTIGATOR COMPLETION DATE: 07-FEB-2024.

Additional Manufacturer Narrative · 0

INITIAL REPORT REF TO NATUS COMPLAINT# (B)(4). CAPA003910 AND CAPA003957 PREVIOUSLY CREATED TO ADDRESS THIS ISSUE. ECO##27338 WAS IMPLEMENTED :HOOKS ADDED TO HOLD THE UPPER MAST TO THE CROSS PLATE.TABS AND SLOTS ADDED TO HOLD THE MOUNTING AREA OF THE MAST TO THE CROSS PLATE. PER QMS-004442 COMPLAINT HISTORIES ARE REVIEWED ROUTINELY PER QUALITY SYSTEM REQUIREMENTS AND ANY COMPLAINT TRENDS ARE ASSESSED AND DOCUMENTED AS PART OF THESE REVIEWS. PER DOC-010378 XLTEK EEG PSG RISK ANALYSIS SPREADSHEET, HAZARD ID - 6.11, SEVERITY 11- CRITICAL, THE RISK IS CONSIDERED MODERATE. A RISK REVIEW IS NOT REQUIRED AS THIS COMPLAINT DOES NOT DESCRIBE A NEW FAILURE MODE OR NEW HARM AND THE EXISTING HAZARD SEVERITY AND/OR PROBABILITY OF OCCURRENCE HAS NOT CHANGED. A DHR REVIEW IS NOT APPLICABLE BECAUSE, PRIOR TO THE REPORTED ISSUE THE DEVICE WAS IN SERVICE FOR 2 OR MORE YEARS AND A MANUFACTURING DEFECT IS VERY UNLIKELY. INSTALL DATE: (B)(6) 2020. FURTHER REVIEW TO BE CARRIED OUT.

Description of Event or Problem · 0

IP PTZ ERGOJUST VIDEO EXTENSION - CART HAS CRACKED VIDEO EXTENSION. PICTURES PROVIDED OF THE FAILURE WERE REVIEWED AND IT WAS NOTED THE BRACKET DOES NOT LOOK TO BE INSTALLED ON THE CUSTOMER'S EQUIPMENT. NO INJURIES.

Description of Event or Problem · 0

IP PTZ ERGOJUST VIDEO EXTENSION - CART HAS CRACKED VIDEO EXTENSION. PICTURES PROVIDED OF THE FAILURE WERE REVIEWED AND IT WAS NOTED THE BRACKET DOES NOT LOOK TO BE INSTALLED ON THE CUSTOMER'S EQUIPMENT. NO INJURIES.

Description of Event or Problem · 0

IP PTZ ERGOJUST VIDEO EXTENSION: CART HAS CRACKED VIDEO EXTENSION. PICTURES PROVIDED OF THE FAILURE WERE REVIEWED AND IT WAS NOTED THE BRACKET DOES NOT LOOK TO BE INSTALLED ON THE CUSTOMER'S EQUIPMENT. NO INJURIES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
482950 IP-EC-VIDEO-EXT IP-EC-VIDEO-EXT OMB NATUS MEDICAL INCORPORATED IP-EC-VIDEO-EXT 00382830058377

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown