inforMED
MalfunctionMPO

NOVAPLUS INFANT HEEL WARMER SQUEEZE

Received Apr 26, 2023 · Event occurred Mar 31, 2023

Report 1423537-2023-00914 · MDR key 16812632

Device

Generic name

Infant Heel Warmer (chemical Heat Pack)

Manufacturer

Mo016 Mo-moberly

Model number

V11460-010

Catalog number

V11460-010

Lot number

V2S056 E

Product problems

  • Burst Container or Vessel
  • Burst Container or Vessel

Patient

Female

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Description of Event or Problem

CUSTOMER REPORTED NURSE WAS SQUEEZING TO ACTIVE THE HEEL WARMER WHEN THE BAG EXPLODED INTO HER FACE, HAIR, CHEST, AND ABDOMEN. NO INJURY REPORTED.

Additional Manufacturer Narrative

THE SAMPLE WAS NOT RETURNED FOR INVESTIGATION; THEREFORE, THE ROOT CAUSE REMAINS UNKNOWN. DEVICE HISTORY RECORD REVIEW WAS COMPLETED ON THE REPORTED LOT NUMBER V2S056. THE LOT WAS FOUND TO HAVE BEEN MANUFACTURED AND RELEASED TO PREDETERMINED SPECIFICATIONS. NO ANOMALIES WERE FOUND DURING REVIEW OF THE RECORDS. NO FURTHER ACTION WILL BE TAKEN AT THIS TIME. CARDINAL HEALTH WILL CONTINUE TO MONITOR COMPLAINT TRENDS FOR THIS REPORTED ISSUE.