inforMED
MalfunctionFSR

ANCILLARY, HEADBAND UL PLUS BI

Received Aug 22, 2014

Report 1222895-2014-00020 · MDR key 4077371

Device

Generic name

Na

Catalog number

AX1375BIF

Product problems

  • Thermal Decomposition of Device
  • Overheating of Device

Patient

Not reported

  • No Consequences Or Impact To Patient

Narrative

Additional Manufacturer Narrative

TO DATE THE DEVICE INVOLVED IN THE REPORTED INCIDENT HAS NOT BEEN RECEIVED FOR EVALUATION. AN INVESTIGATION HAS BEEN INITIATED BASED ON THE REPORTED INFORMATION.

Description of Event or Problem

CUSTOMER INITIALLY REPORTS A PERSON USING INTEGRA HEADLIGHT SUFFERED A BURN TO THE HEAD FROM THE MODULE MEETING WHEN USING OUR MLX LIGHT SOURCE. (B)(4) 2014, REGIONAL BUSINESS MANAGER FOR INTEGRA REPORTED THAT THE HOSPITAL RISK MANAGER INFORMED HIM THAT THERE WAS NO BURN TO ANYONE, NO HARM DONE. (B)(4) 2014, DEALER CONFIRMS THIS IS THE DEVICE THAT BURNED THROUGH THE MELTING. (B)(4)2014, ALTHOUGH RISK MANAGER PROMISED ANSWERS TO EMAIL, NONE RECEIVED YET. NUMBER 1 OF 3 DEVICES REPORTED.