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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BRAEMAR MANUFACTURING, LLC C6 MCOT PPM

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BRAEMAR MANUFACTURING, LLC C6 MCOT PPM Back to Search Results
Model Number 02-01606
Device Problems Overheating of Device (1437); Data Problem (3196)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 12/18/2023
Event Type  malfunction  
Manufacturer Narrative
It was reported that while charging the sensor a purple light came on and when the sensor was removed from the charger it was noted the sensor was hot and there were burn marks.The device was returned.Device was inspected for general physical integrity and found device was melted by the bottom contacts.The device has a crack on the front left side and is cracked over the qr code and continues down to the center contacts.Device was not able to be heat stress tested or ats (automated test system) due to the melting near the contacts.The battery is bulging and cracking the enclosure of the sensor.The sensor was opened to see if there was internal damage and found corrosion on all the boards.The battery has expanded and has signs of moisture under the yellow tape.Allegation is confirmed.
 
Event Description
It patient reported that they charged the snesor and the purple light came on the sensor.The patient took the sensor off the charger and reported that the sensor was hot and had burn marks on the sensor.The patient was concerned that data was not being sent and that the sensor was not working.The patient services rep confirmed that (b)(6) 2023 was the last day data was received.The patient was advised to return the device.A replacement kit was ordered and their service was extended.No patient harm was repoted to the patient.
 
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Brand Name
C6 MCOT PPM
Type of Device
C6 MCOT PPM
Manufacturer (Section D)
BRAEMAR MANUFACTURING, LLC
1285 corporate center drive
suite 150
eagan MN 55121
Manufacturer (Section G)
BRAEMAR MANUFACTURING, LLC
1285 corporate center drive
suite 150
eagan MN 55121
Manufacturer Contact
beverly okoh
1285 corporate center drive
suite 150
eagan, MN 55121
MDR Report Key18566937
MDR Text Key333519268
Report Number2133409-2024-00003
Device Sequence Number1
Product Code DSI
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K081444
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Consumer,Company Representative,Distributor
Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date 12/27/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received01/23/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Model Number02-01606
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer12/26/2023
Date Manufacturer Received12/27/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured11/16/2020
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
Patient Age82 YR
Patient SexFemale
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