inforMED
InjuryFSZ

MAST QUADRANT RETRACTOR SYSTEM

Received Sep 10, 2009 · Event occurred Jul 17, 2009

Report 1030489-2009-00833 · MDR key 1469154

Device

Generic name

Illumination

Model number

NA

Catalog number

9560658

Lot number

UNK

Product problems

  • Component(s), overheating of

Patient

Not reported

  • Burn(s)

Narrative

Description of Event or Problem

IT WAS REPORTED THAT THE LIGHT SOURCE CORD BURNED THE PT AT LOWER BACK DURING USE AND CAUSED A TWO INCHES DIAMETER SECOND DEGREE BURN TO THE PT. NO OTHER PT COMPLICATIONS WERE REPORTED.

Additional Manufacturer Narrative

DEVICE WAS NOT RETURNED TO THE MANUFACTURER FOR EVALUATION. WE ARE UNABLE TO DETERMINE THE CAUSE OF THE EVENT.