BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NATUS DISPOSABLE DISC ELECTRODES

    MDR report key: 4929566 · Received July 21, 2015

    Report

    Report Number
    3010611950-2015-00005
    Event Type
    Injury
    Date Received
    July 21, 2015
    Date of Event
    June 30, 2015
    Report Date
    July 2, 2015
    Manufacturer
    NATUS NEUROLOGY, INCORPORTAED
    Product Code
    GXY
    PMA / PMN Number
    K850108
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MO, US
    Reporter Occupation
    NURSE

    Narratives

    Additional Manufacturer Narrative · 1

    1) REGISTERED INTERNALLY AS A COMPLAINT ((B)(4)) FOR FURTHER INVESTIGATION BY MANUFACTURER. 2) THE ELECTRODES DESCRIBED ARE MANUFACTURED FOR NATUS NEUROLOGY INC. BY A CONTRACT MANUFACTURER. 3) SAMPLES TAKEN FROM THE SAME LOT OF PRODUCT WERE EVALUATED BY THE CONTRACT MANUFACTURER AND FOUND TO MEET ALL MANUFACTURING SPECIFICATIONS. 4) A SEPARATE MDR HAS BEEN CREATED AND SUBMITTED FOR THE EQUIPMENT USED (REF MDR 3010611950-2015-00003). 5) ELECTRO-CAUTERY EQUIPMENT WAS IN USE BY THE COMPLAINANT AT THE SAME TIME AS THE NATUS DEVICE IN QUESTION. THERE ARE KNOWN RISKS ASSOCIATED WITH SUCH DEVICE TO DEVICE COMBINATIONS WHERE ELECTRODES CAN INTERCEPT STRAY RADIO FREQUENCY ENERGY AND RESULT IN THERMAL HEATING. NATUS SAFETY INFORMATION SUPPLIED TO END USERS STATES SUCH INTERACTIONS EXIST AND WARNS END USERS THAT ELECTRODE DISCONNECTION MAY BE NEEDED TO AVOID SUCH INTERACTIONS (REF NATUS SAFETY REFERENCE GUIDE, LABEL #269-594705).

    Description of Event or Problem · 1

    PATIENT WAS BURNED DURING SPINAL FUSION AT THE SIDE OF STIMULATING ELECTRODES. PROCEDURE WAS 6 -- 7 HOURS. CUSTOMER WAS ALSO USING AN ELECTRO-CAUTERY INSTRUMENT (NOT A NATUS DEVICE).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    471204 NATUS DISPOSABLE DISC ELECTRODES ELECTRODE GXY NATUS NEUROLOGY, INCORPORTAED 019-415000 406609

    Patients

    Seq Age Sex Outcome Treatment
    1 13 YR Other