FDA Adverse Event Other Summary report: N

CERETOM NL-3000

MDR report key: 2608658 · Received May 31, 2012

Report

Report Number
3004938766-2012-00001
Event Type
Other
Date Received
May 31, 2012
Date of Event
May 8, 2012
Report Date
May 17, 2012
Manufacturer
NEUROLOGICA, CORPORATION
Product Code
JAK
PMA / PMN Number
K051765
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS RESULTED IN THE FSE'S HAND BEING BURNED AND NEEDING MEDICAL INTERVENTION. THE MOBILE CT SCANNER AND ANY OF IT'S ACCOMPANYING ACCESSORIES DID NOT INDUCE THIS INJURY, WHICH IS ULTIMATELY THE RESULT OF THE FSE'S INVOLUNTARY GRIPPING OF THE SOLDERING IRON. THE FSE WAS TREATED WITH A DRESSING AND RETURNED TO WORK.

Description of Event or Problem · 1

DURING ATTEMPTED REPAIR OF A SUBSYSTEM IN OUR MOBILE CT SCANNER, A NEUROLOGICA FIELD SERVICE ENGINEER (FSE) UNINTENTIONALLY GRABBED HOLD OF A LIVE SOLDERING IRON.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CERETOM NL-3000 X-RAY COMPUTED TOMOGRAPHY SYSTEM JAK NEUROLOGICA, CORPORATION NL3000 NA

Patients

Seq Age Sex Outcome Treatment
1 54 YR Required Intervention