VIKING SELECT
Report
- Report Number
- 3010611950-2015-00004
- Event Type
- Injury
- Date Received
- July 30, 2015
- Date of Event
- July 6, 2015
- Report Date
- July 8, 2015
- Manufacturer
- NATUS NEUROLOGY, INCORPORTAED
- Product Code
- IKN
- PMA / PMN Number
- K890495
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MO, US
- Reporter Occupation
- NURSE
Narratives
1) REGISTERED INTERNALLY AS A COMPLAINT (REFERENCE (B)(4)) FOR FURTHER INVESTIGATION BY MANUFACTURER. 2) THE EQUIPMENT WAS EVALUATED AT THE COMPLAINANTS LOCATION BY A TRAINED NATUS FIELD SERVICE TECHNICIAN AND FOUND TO BE OPERATING ACCEPTABLY . COMPONENTS RELATED TO ELECTRODE CONNECTION AND STIMULATING FUNCTIONS WERE RETURNED TO THE MANUFACTURER FOR FURTHER EVALUATION. TESTING INCLUDED ELECTRICAL AND STIMULUS FUNCTION TESTING. THAT EVALUATION CONCLUDED THAT THOSE COMPONENTS WERE FOUND TO BE OPERATING NORMALLY AND THERE WERE NO INDICATIONS THAT A MALFUNCTION OF THOSE COMPONENTS HAD CONTRIBUTED TO THE BURNS AT THE ELECTRODE SITES. 3) THE ELECTRODES USED IN CONJUNCTION WITH THIS EQUIPMENT WERE REPORTED UNDER A SEPERATE MDR (REFERENCE 3010611950-2015-00006). 4) 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 #(B)(4)).
PATIENT WAS BURNED DURING SPINAL FUSION SURGERY AT THE SITE OF EMG STIMULATING ELECTRODES (ONE BURN ON LEFT ELBOW (~4MM X 3MM) AND TWO BURNS ON LEFT ANKLE (ONE A PINPOINT, THE SECOND ~ 5MM X 7MM)). 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 |
|---|---|---|---|---|---|---|---|
| 496366 | VIKING SELECT | ELECTROMYGRAPH | IKN | NATUS NEUROLOGY, INCORPORTAED | 982A0403 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 13 YR | Other |