FDA Adverse Event
Injury
Summary report: N
COMFORT COOL THUMB CMC RESTRICTION SPLINT
MDR report key: 6982132
·
Received October 26, 2017
Report
- Report Number
- 1000124207-2017-00006
- Event Type
- Injury
- Date Received
- October 26, 2017
- Date of Event
- August 25, 2016
- Report Date
- October 11, 2017
- Manufacturer
- NORTH CCOAST MEDICAL, INC.
- Product Code
- ILH
- PMA / PMN Number
- EXEMPT
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Additional Manufacturer Narrative · 1
NORTH COAST MEDICAL BECAME AWARE OF THIS ISSUE ON (B)(4) 2017 FROM A REPORT BY: (B)(6) OF (B)(6) . THIS WAS AFTER (B)(4) OF (B)(4) SENT (B)(4) AN INCIDENT REPORT INVESTIGATION SCHEME, FILE REFERENCE: (B)(4). AFTER LEARNING OF THIS INCIDENT NORTH COAST MEDICAL, INC. PERFORMED A MATERIAL TEST ON A SAMPLE HAND SPLINT (PATIENT DID NOT RETURN THE ORIGINAL UNIT), AND THE TESTS CONCLUSION WAS "PASS".
Description of Event or Problem · 1
PATIENT EXPERIENCED AN ALLERGIC REACTION TO VELCRO.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 759631 | COMFORT COOL THUMB CMC RESTRICTION SPLINT | COMFORT COOL | ILH | NORTH CCOAST MEDICAL, INC. | NC79557 | N/A |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |