inforMED
MalfunctionJOS

PED RETURN ELEC

Received Mar 9, 2015 · Event occurred Feb 12, 2015

Report 1717344-2015-00181 · MDR key 4581152

Device

Generic name

Es Accesory

Manufacturer

Covidien Lp

Model number

E751025

Catalog number

E751025

Product problems

  • Insufficient Device Problem Information

Patient

Not reported

  • Burn, Thermal

Narrative

Description of Event or Problem

THE CUSTOMER REPORTED THAT FOLLOWING AN INGUINAL HERNIA PROCEDURE, A BURN MARK WAS NOTED AT THE RETURN PAD SITE ON A MALE INFANT,(B)(6), THE RETURN PAD HAD BEEN PLACED ON THE LOWER PART OF THE PATIENT'S BACK. THE DEGREE OF BURN WAS NOT KNOWN. THE AREA WAS BANDAGED. THERE WAS ALSO RESIDUE OF THE ANTISEPTIC YELLOW WASH SOLUTION AROUND THE AREA.

Additional Manufacturer Narrative

(B)(4). DATE OF INITIAL REPORT: 03/09/2015. THE RETURN OF THE INCIDENT SAMPLE HAS BEEN REQUESTED. TO DATE, IT HAS NOT BEEN RECEIVED FOR EVALUATION. ADDITIONAL QUESTIONS IN REGARD TO THE INCIDENT HAVE BEEN ASKED. IF THE SAMPLE IS RECEIVED, OR IF ADDITIONAL INFORMATION PERTINENT TO THE INCIDENT IS OBTAINED, A FOLLOW-UP REPORT WILL BE SUBMITTED.