FDA Adverse Event
Injury
Summary report: N
REVI SYSTEM
MDR report key: 25202088
·
Received May 18, 2026
Report
- Report Number
- 3012239564-2026-00024
- Event Type
- Injury
- Date Received
- May 18, 2026
- Date of Event
- June 26, 2024
- Report Date
- May 18, 2026
- Manufacturer
- BLUEWIND MEDICAL LTD
- Product Code
- QXM
- UDI-DI
- 07290017912011
- PMA / PMN Number
- K240037
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NL
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
BLUEWIND HAS ADOPTED MORE STRINGENT REPORTING CRITERIA FOR IMPLANT-RELATED COMPLAINTS STARTING (B)(6) 2026. A RETROSPECTIVE REVIEW OF TWO YEARS OF COMPLAINT DATA, COVERING THE PERIOD FROM (B)(6) 2024 TO (B)(6) 2026, WAS PERFORMED. A TOTAL OF 543 PATIENT CASES WERE REEVALUATED. OF THESE, 68 CASES INVOLVED PATIENT INFECTION, PAIN, WOUND HEALING ISSUES, IMPLANT FAILURE, OR SURGICAL COMPLICATIONS. THESE 68 CASES WERE REASSESSED AGAINST THE UPDATED REPORTING CRITERIA FOR IMPLANT-RELATED COMPLAINTS, AND FOUR COMPLAINTS WERE DETERMINED TO BE REPORTABLE UNDER THE NEW CRITERIA. COMPLAINT (B)(4) IS ONE OF FOUR REPORTABLE CASES.
Description of Event or Problem · 0
PATIENT EXPERIENCED ELECTRICAL SHOCKS WHEN USING THE DEVICE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 393002 | REVI SYSTEM | IMPLANTED TIBIAL ELECTRICAL URINARY, PRODUCT CODE: QXM | QXM | BLUEWIND MEDICAL LTD | MA-1007-0600_US_CM | 07290017912011 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |