FDA Adverse Event Malfunction Summary report: N

CLAVIS EMG/STIM DEVICE

MDR report key: 17964097 · Received October 19, 2023

Report

Report Number
3005581270-2023-00004
Event Type
Malfunction
Date Received
October 19, 2023
Date of Event
May 25, 2023
Report Date
July 16, 2024
Manufacturer
NATUS MANUFACTURING LIMITED
Product Code
BXN
PMA / PMN Number
K062478
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

FOLLOW UP 001 REF NATUS COMPLAINT# (B)(4). IT WAS CONFIRMED THAT THIS EVENT WAS NOT RELATED TO THE DANTEC CLAVIS DEVICE. THE DEVICE WAS NOT RETURNED FOR INVESTIGATION AS THE STUDY AUTHOR CONFIRMED THAT THE ADVERSE EFFECTS NOTED WERE NOT DUE TO THE DANTEC CLAVIS DEVICE. A DEVICE HISTORY RECORD REVIEW IS NOT APPLICABLE AS THE AUTHOR OF THE STUDY CONFIRMED THAT THE DANTEC CLAVIS DEVICE DID NOT MALFUNCTION OR CAUSE THE ADVERSE EVENT. NO SERIAL NUMBER WAS PROVIDED BY THE STUDY AUTHOR AS THEY CONFIRMED THE ADVERSE EFFECTS NOTED WERE NOT DUE TO A MALFUNCTION OF THE DANTEC CLAVIS DEVICE. COMPLAINTS ARE REVIEWED ROUTINELY PER QUALITY SYSTEM REQUIREMENTS ((B)(4). CORPORATE TRENDING AND ANALYSIS PROCEDURE) COMPLAINT TRENDS ARE ASSESSED AS PART OF THESE REVIEWS. A REVIEW OF COMPLAINT TRENDING IS COMPLETED QUARTERLY. LAST REVIEW (B)(4). FAILURE CONFIRMED: NO. INVESTIGATION RESULT CODE: NEURO SBU/NO ISSUES NOTED. CLOSURE RATIONALE: COMPLAINT COULD NOT BE VERIFIED, MONITOR FOR FUTURE OCCURRENCE.

Additional Manufacturer Narrative · 0

INITIAL REPORT (REF NATUS COMPLAINT # (B)(4).) NATUS TO REACH OUT FOR FURTHER INFORMATION TO ENSURE ALL RELATED DETAILS ARE RECEIVED AND DOCUMENT. LOT / SERIAL NUMBER TO BE CONFIRMED. THE REPORT WAS WRITTEN BY: (B)(6).

Additional Manufacturer Narrative · 0

FOLLOW UP 002 REF NATUS COMPLAINT# (B)(4). CORRECTION TO SECTION D - **UDI RELATED DATA QUALITY UPDATES ONLY.**

Description of Event or Problem · 0

PART 9015A0012 - CLAVIS EMG/STIM DEVICE. DURING A REVIEW OF A LITERATURE REPORT (J REHABIL MED 2023; 55: JRM11963 RESULTS PAGE 4). WITH REFERENCE TO EFFECTIVENESS OF ULTRASOUND-GUIDED VS ELECTRICAL-STIMULATIONGUIDED BOTULINUM TOXIN INJECTIONS IN TRICEPS SURAE SPASTICITY AFTERSTROKE: A RANDOMIZED CONTROLLED STUDY, THE FOLLOWING INFORMATION WAS DOCUMENTED: THE CALF PRURITUS OCCURRED THE DAY AFTER BOTULINUM TOXIN INJECTION, WITHOUT A RASH, AND RESOLVED COMPLETELY IN LESS THAN 24 H.

Description of Event or Problem · 0

PART 9015A0012 - CLAVIS EMG/STIM DEVICE DURING A REVIEW OF A LITERATURE REPORT (J REHABIL MED 2023; 55: JRM11963 RESULTS PAGE 4). WITH REFERENCE TO EFFECTIVENESS OF ULTRASOUND-GUIDED VS ELECTRICAL-STIMULATIONGUIDED BOTULINUM TOXIN INJECTIONS IN TRICEPS SURAE SPASTICITY AFTERSTROKE: A RANDOMIZED CONTROLLED STUDY, THE FOLLOWING INFORMATION WAS DOCUMENTED: THE CALF PRURITUS OCCURRED THE DAY AFTER BOTULINUM TOXIN INJECTION, WITHOUT A RASH, AND RESOLVED COMPLETELY IN LESS THAN 24 H.

Description of Event or Problem · 0

PART 9015A0012 - CLAVIS EMG/STIM DEVICE. DURING A REVIEW OF A LITERATURE REPORT (J REHABIL MED 2023; 55: JRM11963 RESULTS PAGE 4). WITH REFERENCE TO EFFECTIVENESS OF ULTRASOUND-GUIDED VS ELECTRICAL-STIMULATIONGUIDED BOTULINUM TOXIN INJECTIONS IN TRICEPS SURAE SPASTICITY AFTERSTROKE: A RANDOMIZED CONTROLLED STUDY, THE FOLLOWING INFORMATION WAS DOCUMENTED: THE CALF PRURITUS OCCURRED THE DAY AFTER BOTULINUM TOXIN INJECTION, WITHOUT A RASH, AND RESOLVED COMPLETELY IN LESS THAN 24 H.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
86837 CLAVIS EMG/STIM DEVICE CLAVIS EMG/STIM DEVICE BXN NATUS MANUFACTURING LIMITED 9015A0012

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown