BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ICEMAN THERAPY UNIT

    MDR report key: 2161955 · Received July 11, 2011

    Report

    Report Number
    9616086-2011-00075
    Event Type
    Injury
    Date Received
    July 11, 2011
    Date of Event
    June 1, 2010
    Report Date
    July 6, 2011
    Manufacturer
    DJ ORTHOPEDICS DE MEXICO
    Product Code
    ILO
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    SVC OF SUMMONS AND COMPLAINT WAS MANUFACTURER'S FIRST NOTICE OF THIS EVENT. PLAINTIFF'S COUNSEL CLAIMS IN THE COMPLAINT THAT THE PT SUFFERED A PERSONAL INJURY FOLLOWING THE APPLICATION OF CRYOTHERAPY (ICEMAN) FOR THE TREATMENT OF AN UNDERLYING RIGHT SHOULDER INJURY. THERE IS NO INFO IN THE COMPLAINT ABOUT THE PERSONAL INJURY OR THE TEMPERATURE AT WHICH THE DEVICE WAS SET. THE CO HAS BEEN UNABLE TO CONFIRM THE MFR OF OR INSPECT THE DEVICE. BECAUSE THE MATTER IS IN LITIGATION, IT HAS BEEN TURNED OVER TO OUTSIDE COUNSEL FOR FURTHER INVESTIGATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ICEMAN THERAPY UNIT WATER CIRCULATING HOT OR COLD PACK ILO DJ ORTHOPEDICS DE MEXICO

    Patients

    Seq Age Sex Outcome Treatment
    1 Other