FDA Adverse Event
Injury
Summary report: N
LUMOS
MDR report key: 19839863
·
Received July 26, 2024
Report
- Report Number
- 3006437518-2024-00011
- Event Type
- Injury
- Date Received
- July 26, 2024
- Date of Event
- July 5, 2024
- Report Date
- September 27, 2024
- Manufacturer
- DKK DAI-ICHI SHOMEI CO., LTD.
- Product Code
- FSY
- PMA / PMN Number
- K071698
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
WHEN USING THE LUMOS WITH THE IOBAN 2 DRAPE(3M), THE SURGEON NOTICED THAT THE IOBAN 2 DRAPE MELTED ONTO THE PATIENT CAUSING A BURN. THE LUMOS PRODUCED HIGHT TEMPERATURES, SUCH THAT ITS OPERATION IS COMPROMISED OR HARM IS CAUSED (OVERHEATING THAT PRODUCES MELTING OF COMPONENTS OR AUTOMATIC SHUTDOWN).
Description of Event or Problem · 0
WHEN USING THE LUMOS WITH THE IOBAN 2 DRAPE (3M), THE SURGEON NOTICED THAT THE IOBAN 2 DRAPE MELTED ONTO THE PATIENT CAUSING A BURN. THE LUMOS PRODUCED HIGHT TEMPERATURES, SUCH THAT ITS OPERATION IS COMPROMISED OR HARM IS CAUSED (OVERHEATING THAT PRODUCES MELTING OF COMPONENTS OR AUTOMATIC SHUTDOWN).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1777127 | LUMOS | CAMERA, SURGICAL, CEILING MOUNTED, PRODUCT CODE: FSY | FSY | DKK DAI-ICHI SHOMEI CO., LTD. | LUMOS |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown | Hospitalization |