MAUDE Adverse Event Report: LIFEWATCH SERVICES, INC. LIFEWATCH MOBILE CARDIAC TELEMETRY MCT 1-LEAD: UNIVERSAL GATEWAY

Model Number MCT 1L

Device Problem Patient Device Interaction Problem (4001)

Patient Problem Patient Problem/Medical Problem (2688)

Event Date 04/17/2020

Event Type  Injury  

Manufacturer Narrative

A dhr review was performed, with no contributing factors identified.The affected device (patch) has not been received by lifewatch services, inc.The patient reported sensitive skin / allergy described as allergic to adhesive.The patient was allegedly prescribed a kenalog shot and triamcinolone.1% cream (apply 3x a day).Based on information available the patient only wore the device for one day before experiencing skin irritation symptoms.Skin irritation is a known inherent risk of the device.The mct-1l user guide (sup559 rev.D) includes warning statements stating the following: the mct 1lp is not intended for use on patients with skin or soft tissue damage in the area where the patch is placed (such as burns, irritation, infections, wounds, etc.).If you develop a skin irritation, remove the mct 1l patch and seek medical attention.Reddening or slight irritation of the skin from the mct 1l patch is normal.Contact lifewatch services 1.800.517.6330 if you experience any irritation problems.The patient contacting materials of the patch system have been tested for cytotoxicity, sensitization and skin irritation per the following standards: cytotoxicity iso 10993-5, sensitization iso 10993-10, irritation iso 10993-10.No additional information is known to lifewatch services, inc.At this time.

Event Description

Patient communication of consulting a healthcare professional due to allergic reaction/skin irritation where treatment was prescribed.

• Brand Name: LIFEWATCH MOBILE CARDIAC TELEMETRY MCT 1-LEAD: UNIVERSAL GATEWAY
• Type of Device: LIFEWATCH MOBILE CARDIAC TELEMETRY MCT 1-LEAD: UNIVERSAL GATEWAY
• Manufacturer (Section D): LIFEWATCH SERVICES, INC.; 10255 w higgins rd.; suite 700; rosemont, il
• Manufacturer (Section G): LIFEWATCH SERVICES, INC.; 10255 w higgins rd.; suite 700; rosemont, il
• Manufacturer Contact: tahnee mehta ; 10255 w higgins rd.; suite 700; rosemont, il ; 5312011
• MDR Report Key: 10058343
• MDR Text Key: 195645383
• Report Number: 3027765-2020-00004
• Device Sequence Number: 1
• Product Code: DSI
• UDI-Device Identifier: 00850725007040
• UDI-Public: 00850725007040
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K151269
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: consumer
• Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial
• Report Date: 05/14/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 05/14/2020
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Lay User/Patient
• Device Model Number: MCT 1L
• Device Catalogue Number: MCT 1L: UNIVERSAL GATEWAY
• Device Lot Number: UNKNOWN/UNREPORTED
• Was Device Available for Evaluation?: No
• Event Location: Home
• Date Manufacturer Received: 04/22/2020
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: No
• Type of Device Usage: Reuse
• Patient Sequence Number: 1
• Patient Outcome(s): Other
• Patient Age: 66 YR