FDA Adverse Event Injury Summary report: N

MOBILE CARDIAC OUTPATIENT TELEMETRY PATCH SYSTEM (MCOT)

MDR report key: 8876010 · Received August 8, 2019

Report

Report Number
2133409-2019-00001
Event Type
Injury
Date Received
August 8, 2019
Report Date
August 8, 2019
Manufacturer
BRAEMAR MANUFACTURING, LLC
Product Code
DSI
UDI-DI
B146C6S0
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

BRAEMAR MANUFACTURING IS NO LONGER INVESTIGATING THIS INCIDENT AND CONSIDERS THIS MATTER CLOSED.

Description of Event or Problem · 1

ON (B)(6) 2019, BRAEMAR MANUFACTURING, LLC WAS MADE AWARE OF PATIENT ALLEGATION OF BURN/SKIN REACTION. THE PATIENT ALLEGEDLY WORE A C6 PATCH MONITOR IN EVENT MODE AND INDICATED THAT HER SKIN REACTED ADVERSELY TO THE MONITOR AND THAT SHE EXPERIENCED A SKIN BURN. THE PATIENT INDICATED THAT SHE DID NOT EXPERIENCE AN ADVERSE EVENT WHEN SHE WORE THE FIRST PATCH AND THAT THE EVENT OCCURRED DURING THE SECOND WEEK OF USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
669861 MOBILE CARDIAC OUTPATIENT TELEMETRY PATCH SYSTEM (MCOT) MOBILE CARDIAC OUTPATIENT TELEMETRY PATCH SYSTEM (MCOT) DSI BRAEMAR MANUFACTURING, LLC 900-0634-00 B146C6S0

Patients

Seq Age Sex Outcome Treatment
1