FDA Adverse Event
Injury
Summary report: N
SEEQ
MDR report key: 7101744
·
Received December 8, 2017
Report
- Report Number
- 3010824444-2017-00010
- Event Type
- Injury
- Date Received
- December 8, 2017
- Date of Event
- October 7, 2017
- Report Date
- December 8, 2017
- Manufacturer
- EPIC TECHNOLOGIES, LLC
- Product Code
- DSI
- PMA / PMN Number
- K133701
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- KS, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
NO EVAL OTHER DESCRIPTION: PHYSICAL PRODUCT ANALYSIS IS NOT REQUIRED FOR SKIN DISCOMFORT/IRRITATION COMPLAINTS BECAUSE THERE IS NO WAY TO DETERMINE THE LEVEL OF SKIN DISCOMFORT/IRRITATION THROUGH ANALYSIS OF THE PHYSICAL PRODUCT. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.
Description of Event or Problem · 1
IT WAS REPORTED THAT THE PATIENT REMOVED THE WEARABLE SENSOR AND "EXPERIENCED 3RD DEGREE BURNS FROM METAL." IT IS UNKNOWN IF THE SENSOR WAS REPLACED. NO FURTHER PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 880549 | SEEQ | DETECTOR AND ALARM, ARRHYTHMIA | DSI | EPIC TECHNOLOGIES, LLC | P01575-010 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 64 YR | Other |