MAUDE Adverse Event Report: 3M CANADA COMPANY 3M¿ ECG MONITORING ELECTRODES, FOAM DIAPHORETIC; ELECTROCARDIOGRAPHIC ELECTRODE

Model Number 2228

Device Problem Human-Device Interface Problem (2949)

Patient Problems Erythema (1840); Itching Sensation (1943)

Event Date 05/11/2023

Event Type  Injury  

Event Description

A 30-year-old male allegedly experienced a serious injury noted as redness and an itching sensation with the use of the 3m¿ ecg monitoring electrodes, foam diaphoretic, 2228 lot: 20220504.The area was wiped with alcohol and an intravenous infusion of anti-allergic medicine was administered.No additional information is available.

Manufacturer Narrative

H10: product sample was not returned to 3m for analysis.Without a sample, it is not possible to perform any tests to determine if the device met specifications.Without additional information, it is not possible to definitively determine the root cause.The instructions for use states, 3m¿ ecg monitoring electrodes, foam diaphoretic, 2228 are disposable, intended for single use, and has been tested for up to 3 days wear.For proper skin management and to minimize skin irritation: avoid placing an electrode on an irritated skin site.Do not abrade a skin site more than one time.Avoid removing electrodes frequently and/or reapplying to the same skin site.Avoid placing electrodes on skin still wet from an alcohol wipe (dry thoroughly).Assess electrode sites periodically.

• Brand Name: 3M¿ ECG MONITORING ELECTRODES, FOAM DIAPHORETIC
• Type of Device: ELECTROCARDIOGRAPHIC ELECTRODE
• Manufacturer (Section D): 3M CANADA COMPANY; 400 route 100; morden, manitoba R6M 1 Z9; CA R6M 1Z9
• Manufacturer (Section G): 3M CANADA COMPANY; 400 route 100; morden, manitoba R6M 1 Z9; CA R6M 1Z9
• Manufacturer Contact: nadia battah ; 3m center, building 275-5w-06; 2510 conway ave; st. paul, MN 55144-1000 ; 6514612670
• MDR Report Key: 17170722
• MDR Text Key: 317629729
• Report Number: 2110898-2023-00051
• Device Sequence Number: 1
• Product Code: DRX
• UDI-Device Identifier: 10707387789524
• UDI-Public: 10707387789524
• Combination Product (y/n): N
• Reporter Country Code: CH
• PMA/PMN Number: EXEMPT
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Foreign,Health Professional,User Facility,Company Representative
• Reporter Occupation: Other Health Care Professional
• Type of Report: Initial
• Report Date: 06/21/2023

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 06/21/2023
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Device Expiration Date: 05/03/2024
• Device Model Number: 2228
• Device Catalogue Number: 2228
• Device Lot Number: 20220504
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Date Manufacturer Received: 05/31/2023
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 05/04/2022
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Required Intervention
• Patient Age: 30 YR
• Patient Sex: Male