KEEOGO - CLINICIAN KIT

Description of Event or Problem

ON (B)(6) 2025, DURING THE EXHOMESEP CLINICAL INVESTIGATION IN FRANCE (PROTOCOL ID-RCB 2021-A03094-37), A 74-YEAR-OLD MALE SUBJECT (PATIENT ID: (B)(6) WITH A PRE-EXISTING DIAGNOSIS OF PRIMARY PROGRESSIVE MULTIPLE SCLEROSIS EXPERIENCED ACUTE CARDIAC SYMPTOMS WHILE PERFORMING A SUPERVISED REHABILITATION EXERCISE SESSION WITH THE KEEOGO DERMOSKELETON SYSTEM. AT 15:00, THE SUBJECT DEVELOPED RETROSTERNAL CONSTRICTIVE CHEST PAIN RADIATING TO THE JAW AND LEFT ARM DURING THE SESSION. SYMPTOMS RESOLVED AFTER STOPPING THE EXERCISE. AT 20:00, CHEST PAIN RECURRED AT REST FOR ABOUT ONE HOUR, WITH BLOOD PRESSURE MEASURED AT 180 MMHG. ECG WAS INCONCLUSIVE. TROPONIN LATER TESTED POSITIVE (INCREASE FROM 10 NG/L TO 35 NG/L). ON (B)(6) 2025 AT 02:00, CHEST PAIN RECURRED AGAIN, REQUIRING ADMISSION TO THE CARDIOLOGY DEPARTMENT FOR SUSPECTED ANGINA/NSTEMI. THE EVENT WAS CLASSIFIED AS LIFE-THREATENING. THE PATIENT REMAINED HOSPITALIZED IN STABLE CONDITION AT THE TIME OF REPORTING. THE KEEOGO DEVICE WAS INSPECTED BY THE STUDY TEAM AND CONFIRMED TO BE FUNCTIONING PROPERLY BEFORE, DURING, AND AFTER THE INCIDENT, WITH NO DEFECT OR MALFUNCTION IDENTIFIED. THE INVESTIGATOR NOTED THE POSSIBILITY THAT THE PHYSICAL EFFORT REQUIRED WHILE USING THE DEVICE DURING EXERCISE MAY HAVE CONTRIBUTED TO THE EVENT. ECG: T WAVE INVERSION IN LEAD T AND AVL; SLIGHT ST DEPRESSION IN V4-V5. BIOLOGICAL RESULTS: POTASSIUM 3.5 MMOL/L; CREATININE 68 [?]MOL/L; EGFR 90 ML/MIN; TROPONIN 12 NG/L THEN 35 NG/L; WBC 6 G/L; HEMOGLOBIN 14.5 G/DL; PLATELETS 220 G/L. ECHOCARDIOGRAPHY: SEVERE HYPOKINESIA OF THE MID-TO-DISTAL INFEROLATERAL WALL, EXTENDING LATERALLY; FINDINGS COMPATIBLE WITH MYOCARDIAL ISCHEMIA. CLINICAL ASSESSMENT: CARDIOPULMONARY EXAM WITHOUT SIGNS OF HEART FAILURE. DATE OF CARDIOLOGY ADMISSION: ON (B)(6) 2025. PRE-EXISTING CONDITION: PRIMARY PROGRESSIVE MULTIPLE SCLEROSIS (PPMS). NO KNOWN CARDIOVASCULAR HISTORY PRIOR TO THE EVENT. RISK FACTORS: AGE, MALE SEX, SEDENTARY LIFESTYLE, HISTORY OF SMOKING CESSATION, FAMILY HISTORY (FATHER HAD MYOCARDIAL INFARCTION BEFORE AGE 50). NO CONCOMITANT MEDICATIONS REPORTED. CONCOMITANT THERAPY: SUPERVISED PHYSICAL REHABILITATION IN CENTER (STARTED ON (B)(6) 2025).

Additional Manufacturer Narrative

THE KEEOGO DERMOSKELETON INVOLVED IN THIS EVENT WAS INSPECTED ON SITE BY THE CLINICAL TEAM AND CONFIRMED TO BE FUNCTIONING PROPERLY BEFORE, DURING, AND AFTER THE INCIDENT. NO DEVICE MALFUNCTION, DEFECT, OR ABNORMAL BEHAVIOR WAS IDENTIFIED. THE ADVERSE EVENT WAS REPORTED TO THE FRENCH COMPETENT AUTHORITY (ANSM) ON 2025-09-18 BY THE MANUFACTURER (B-TEMIA) IN ACCORDANCE WITH EU MDR REQUIREMENTS. AT THIS STAGE, NO REMEDIAL ACTION OR FIELD SAFETY CORRECTIVE ACTION WAS INITIATED. THE PATIENT REMAINS HOSPITALIZED IN STABLE CONDITION. B-TEMIA WILL SUBMIT A SUPPLEMENTAL MDR ONCE ADDITIONAL CLINICAL INFORMATION BECOMES AVAILABLE FROM THE INVESTIGATIONAL SITE (E.G., PATIENT CARDIOVASCULAR HISTORY, CONCOMITANT MEDICATIONS, BASELINE VITAL SIGNS).