FDA Adverse Event Malfunction Summary report: N

NEUROTHERM DISPOSABLE RADIOFREQUENCY CANNULA

MDR report key: 4021337 · Received July 8, 2014

Report

Report Number
3002953813-2014-00006
Event Type
Malfunction
Date Received
July 8, 2014
Date of Event
June 12, 2014
Report Date
June 12, 2014
Manufacturer
NEUROTHERM, INC.
Product Code
GXI
PMA / PMN Number
K000073
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE CANNULA UNDERWENT VISUAL, MECHANICAL, AND PHYSICAL TESTING. NO ABNORMALITIES WERE FOUND. THE NEEDLE INSULATION WAS TESTED AND WAS FOUND TO BE WITHIN SPECIFICATION. PHOTOGRAPHS OF THE BURN SUGGESTED THE CANNULA WAS INSERTED FAR ENOUGH INTO THE PATIENT TO WHERE THE HUB TOUCHED THE SKIN. SIMULATED USE TESTED WAS PERFORMED USING CHICKEN BREAST. THE BURNS WERE REPLICATED WHEN THE CANNULA WAS INSERTED FAR ENOUGH FOR THE HUB TO BE TOUCHING THE MEAT.

Description of Event or Problem · 1

A PATIENT RECEIVED A BURN FROM A CANNULA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
398263 NEUROTHERM DISPOSABLE RADIOFREQUENCY CANNULA DISPOSABLE RADIOFREQUENCY CANNULA GXI NEUROTHERM, INC. S-1510-B-18 140531-1A

Patients

Seq Age Sex Outcome Treatment
1 Other