OAE PEDIATRIC FOAM EAR TIPS 203211

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a user facility report with the FDA on 2017-11-17 for OAE PEDIATRIC FOAM EAR TIPS 203211 manufactured by Natus Medical Inc..

Event Text Entries

[93054264] A total of 64 bags of the oae pediatric foam tips were received. Fourteen foam tips from lot n050217-05 were examined. Upon removal from the plastic packaging, the foam tips are still adequately glued to the inner tubing after a visual inspection. Testing was performed to confirm the alleged malfunction and the failure could not be confirmed. The customer was provided replacement foam tips. Natus instructions include selecting the appropriate size ear tip for the patient, as well as instructions regarding using larger size foam tips for insertion into the ear canal. Natus is investigating this issue through corrective actions at this time.
Patient Sequence No: 1, Text Type: N, H10


[93054265] The customer reported to natus medical that the foam tips of the pediatric foam ear tips are separating from the inner plastic tubing. There has been no report of patient death, injury or delay in patient treatment. No environmental or safety concerns have also been reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3018859-2017-00925
MDR Report Key7042459
Report SourceUSER FACILITY
Date Received2017-11-17
Date of Report2017-10-10
Date Mfgr Received2018-08-01
Device Manufacturer Date2017-05-02
Date Added to Maude2017-11-17
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactJIM FITZGERALD
Manufacturer Street5900 FIRST AVENUE SOUTH
Manufacturer CitySEATTLE WA 98108
Manufacturer CountryUS
Manufacturer Postal98108
Manufacturer Phone5613065818
Manufacturer G1NATUS MEDICAL INC.
Manufacturer Street5900 FIRST AVENUE SOUTH
Manufacturer CitySEATTLE WA 98108
Manufacturer CountryUS
Manufacturer Postal Code98108
Single Use3
Remedial ActionRL
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameOAE PEDIATRIC FOAM EAR TIPS
Generic NameOAE PEDIATRIC FOAM EAR TIPS
Product CodeGWJ
Date Received2017-11-17
Returned To Mfg2017-10-25
Model Number203211
Lot NumberN050217-05
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerNATUS MEDICAL INC.
Manufacturer Address5900 FIRST AVENUE SOUTH SEATTLE WA 98108 US 98108


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2017-11-17

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