RF GROUNDING PAD DISPOSABLE WITH CORD
Received Oct 2, 2018 · Event occurred Sep 6, 2018
Report 3011270181-2018-00044 · MDR key 7928124
Device
Generic name
Standard Rf Cables & Accessories
Manufacturer
Avanos Medical Inc.Model number
PMA-GP-BAYCatalog number
109860601
Lot number
UNKNOWN
Product problems
- Grounding Malfunction
- Grounding Malfunction
Patient
Not reported
- Burn(s)
- Burn(s)
Narrative
Additional Manufacturer Narrative
THE SAMPLE IS REPORTED TO BE AVAILABLE, BUT HAS NOT YET BEEN RECEIVED BY THE MANUFACTURER. A REVIEW OF THE DEVICE HISTORY RECORD IS NOT POSSIBLE AS NO LOT NUMBER WAS PROVIDED. ALL INFORMATION REASONABLY KNOWN AS OF 01-OCT-2018. HAS BEEN INCLUDED IN THIS HEALTH AUTHORITY REPORT. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A FOLLOW-UP HEALTH AUTHORITY REPORT WILL BE PROVIDED. THE INFORMATION PROVIDED BY AVANOS MEDICAL, INC. REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO AVANOS MEDICAL, INC. AVANOS MEDICAL, INC. HAS NO INDEPENDENT KNOWLEDGE OF THE EVENT REPORTED BUT IS RELAYING THE INFORMATION THAT WAS PROVIDED BY THE USER FACILITY WHERE THE INCIDENT OCCURRED. THIS PRODUCT INCIDENT IS DOCUMENTED IN THE AVANOS MEDICAL, INC. COMPLAINT DATABASE AND IDENTIFIED AS COMPLAINT (B)(4). DEVICE NOT RETURNED.
Description of Event or Problem
IT WAS REPORTED THAT DURING THE SECOND BURN THE PAIN MANAGEMENT GENERATOR (PMG) GAVE A TEMPERATURE ERROR MESSAGE. ADDITIONAL INFORMATION RECEIVED (B)(6) 2018 STATED THE FIRST ROUND OF ABLATION WAS SUCCESSFUL. THE LOCATION OF THE GROUNDING PAD WAS THE RIGHT FLANK. THE PROCEDURE WAS A LUMBAR RADIO FREQUENCY (RF) ABLATION. AN UNKNOWN ERROR MESSAGE WAS NOTED. THE PHYSICIAN WAS ABLE TO CONTINUE WITH PROCEDURE. DURING THE SECOND BURN, THE PMG GAVE A TEMPERATURE ERROR MESSAGE, EXACT MESSAGE UNKNOWN. STAFF HEARD A "CRACKLING" NOISE AND A BURN WAS NOTICED UNDER PATIENT'S RIGHT FLANK. THE GROUNDING PAD WAS REMOVED FROM THE RIGHT FLANK AND REPLACED WITH A NEW GROUNDING PAD. A SECOND GROUNDING PAD WAS PLACED ON THE UPPER THIGH AND THE PROCEDURE WAS COMPLETED WITHOUT ISSUE. A WOUND CARE NURSE WAS CONSULTED FOR THE BURN. IT WAS UNKNOWN WHAT SEVERITY OR IF TREATMENT WAS REQUIRED.
Additional Manufacturer Narrative
THE PRODUCT INVOLVED IN THE REPORT HAS BEEN RETURNED AND IS BEING PROCESSED FOR EVALUATION. ALL INFORMATION REASONABLY KNOWN AS OF (B)(6) 2018. HAS BEEN INCLUDED IN THIS HEALTH AUTHORITY REPORT. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A FOLLOW-UP HEALTH AUTHORITY REPORT WILL BE PROVIDED. THE INFORMATION PROVIDED BY AVANOS MEDICAL, INC. REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO AVANOS MEDICAL, INC. AVANOS MEDICAL, INC. HAS NO INDEPENDENT KNOWLEDGE OF THE EVENT REPORTED BUT IS RELAYING THE INFORMATION THAT WAS PROVIDED BY THE USER FACILITY WHERE THE INCIDENT OCCURRED. THIS PRODUCT INCIDENT IS DOCUMENTED IN THE AVANOS MEDICAL, INC. COMPLAINT DATABASE AND IDENTIFIED AS COMPLAINT (B)(4). THIS INFORMATION IS SUBMITTED PURSUANT TO 21CFR803, IN COMPLIANCE WITH THE MEDICAL DEVICE REPORTING REQUIREMENT AND SHOULD NOT BE CONSIDERED TO BE AN ADMISSION THAT AN AVANOS MEDICAL, INC. PRODUCT IS DEFECTIVE OR CAUSED SERIOUS INJURY.
Additional Manufacturer Narrative
THE SAMPLE WAS EVALUATED. NO ISSUE WAS FOUND WITH THE COMPLAINT GROUND PAD. THE FAILURE WAS NOT CONFIRMED. NO ROOT CAUSE WAS IDENTIFIED. ALL INFORMATION REASONABLY KNOWN AS OF (B)(6) 2018. HAS BEEN INCLUDED IN THIS HEALTH AUTHORITY REPORT. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A FOLLOW-UP HEALTH AUTHORITY REPORT WILL BE PROVIDED. THE INFORMATION PROVIDED BY AVANOS MEDICAL, INC. REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO AVANOS MEDICAL, INC. AVANOS MEDICAL, INC. HAS NO INDEPENDENT KNOWLEDGE OF THE EVENT REPORTED BUT IS RELAYING THE INFORMATION THAT WAS PROVIDED BY THE USER FACILITY WHERE THE INCIDENT OCCURRED. THIS PRODUCT INCIDENT IS DOCUMENTED IN THE AVANOS MEDICAL, INC. COMPLAINT DATABASE AND IDENTIFIED AS COMPLAINT (B)(4). THIS INFORMATION IS SUBMITTED PURSUANT TO 21CFR803, IN COMPLIANCE WITH THE MEDICAL DEVICE REPORTING REQUIREMENT AND SHOULD NOT BE CONSIDERED TO BE AN ADMISSION THAT AN AVANOS MEDICAL, INC. PRODUCT IS DEFECTIVE OR CAUSED SERIOUS INJURY.