inforMED
InjuryMOS

SENSE SHOULDER COIL 1.5T 4CH

Received Feb 3, 2015 · Event occurred Jan 9, 2015

Report 1056069-2015-00004 · MDR key 4487167

Device

Generic name

Ch Shoulder

Manufacturer

Invivo Corp

Model number

9896-030-13432

Product problems

  • Insufficient Device Problem Information

Patient

57 YR

  • Tingling
  • Partial thickness (Second Degree) Burn
  • Partial thickness (Second Degree) Burn

Narrative

Additional Manufacturer Narrative

(B)(4). NO DEFINITE ROOT CAUSE FOR THE INJURY AS SUSTAINED BY THE PATIENT COULD BE DETERMINED. THE MOST LIKELY ROOT CASE IS A COMBINATION OF THE TECHNICIAN NOT USING ANY PATIENT VENTILATION IN COMBINATION WITH 8 CONSECUTIVE SCANS WITH HIGH SAR VALUES WITH-OUT PAUSES TO ALLOW FOR THE PATIENT BODY TO COOL DOWN.PRODUCT WAS NOT RETURNED TO THE MANUFACTURER, THE CUSTOMER HAS AN AGREEMENT WITH A THIRD PARTY SERVICE ORGANIZATION WHICH WAS UNABLE TO RETURN THE PRODUCT TO INVIVO.

Description of Event or Problem

A FEMALE PATIENT WAS POSITIONED HEAD FIRST SUPINE AND SCANNED WITH THE SHOULDER COIL FOR AN EXAMINATION OF THE LEFT SHOULDER. THE PATIENT STATED SHE FELT A TINGLING SENSATION AT THE TOP THE LEFT SHOULDER. AFTER THE EXAMINATION A SMALL BUMP WAS OBSERVED THAT DEVELOPED INTO A 4CM SIZE BLISTER ON TOP OF THE LEFT SHOULDER.

Additional Manufacturer Narrative

(B)(4). METHOD, RESULTS, CONCLUSIONS: THE INVESTIGATION IS STILL ONGOING ON THIS EVENT. WHEN THE INVESTIGATION IS COMPLETED A F/U REPORT WILL BE SENT TO THE FDA.

Remedial action

  • Replace