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MalfunctionMPO

NOVAPLUS INFANT HEEL WARMER 4X4IN

Received May 20, 2022 · Event occurred Jan 1, 1980

Report 1423537-2022-00766 · MDR key 14458849

Device

Generic name

Infant Heel Warmer (chemical Heat Pack)

Manufacturer

Cardinal Health

Model number

V11460-010

Catalog number

V11460-010

Lot number

V2A051

Product problems

  • Burst Container or Vessel
  • Burst Container or Vessel

Patient

Female

  • Erythema
  • Erythema

Narrative

Description of Event or Problem

NURSES DESCRIBED THAT WHEN THEY SQUEEZE TO ACTIVATE THE PRODUCT, THE POUCH WOULD RUPTURE, AND THE CONTENTS WOULD SPILL OUT. CUSTOMER REPORTED THAT DURING ACTIVATION, THE INFANT HEEL WARMER RUPTURED ONTO NURSE¿S 2ND AND 3RD DIGIT ON LEFT HAND CAUSING ERYTHEMA AND NUMBNESS. HANDS WERE WASHED WITH SOAP AND WATER. NO FURTHER FOLLOW UP CARE WAS REQUIRED. NURSE REPORTED CURRENTLY THE AFFECTED AREA HAS OCCASIONAL TINGLING AFTER 2 WEEKS. ACTUAL EVENT DATE IS UNKNOWN BY CUSTOMER.

Additional Manufacturer Narrative

THE DEVICE HISTORY REVIEW WAS COMPLETED ON THE REPORTED LOT NUMBER V2A051. THE LOT WAS FOUND TO HAVE BEEN MANUFACTURED AND RELEASED TO PREDETERMINED SPECIFICATIONS. NO ANOMALIES WERE FOUND DURING REVIEW OF THE RECORDS. THE REPORTED EVENT COULD NOT BE CONFIRMED, AS NO SAMPLES WERE RETURNED BY THE CUSTOMER FOR EVALUATION. WITHOUT THE SAMPLE A ROOT CAUSE COULD NOT BE DETERMINED. WE WILL CONTINUE TO MONITOR COMPLAINT TRENDS.