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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MO016 MO-MOBERLY INFANT HEEL WARMER SQUEEZE 4X4IN; INFANT HEEL WARMER (CHEMICAL HEAT PACK)

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MO016 MO-MOBERLY INFANT HEEL WARMER SQUEEZE 4X4IN; INFANT HEEL WARMER (CHEMICAL HEAT PACK) Back to Search Results
Model Number 11460-010T
Medical Device Problem Code Burst Container or Vessel (1074)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/24/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Device history record review was completed on the reported lot v3a209.The lot was found to have been manufactured and released to predetermined specifications.No anomalies were found during review of the records.No samples were returned for investigation due to which a root cause could not be determined.Cardinal health will continue to monitor complaint trends for this reported issue of burst and work to identify improvement activities to minimize reoccurrence.
 
Event or Problem Description
Customer reported ¿the infant heel warmer popped recently, bursting on the nurse's intact skin of hands and on floor.There was no injury and the nurse is fine¿.
 
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Brand Name
INFANT HEEL WARMER SQUEEZE 4X4IN
Common Device Name
INFANT HEEL WARMER (CHEMICAL HEAT PACK)
Manufacturer (Section D)
MO016 MO-MOBERLY
808 w highway 24
moberly MO 65270
Manufacturer (Section G)
MO016 MO-MOBERLY
808 w highway 24
moberly MO 65270
Manufacturer Contact
patricia tucker
3651 birchwood drive
waukegan, IL 60085
8478874151
MDR Report Key16587617
Report Number1423537-2023-00889
Device Sequence Number1700056
Product Code MPO
UDI-Device Identifier10192253061420
UDI-Public10192253061420
Combination Product (Y/N)N
Initial Reporter StateCO
Initial Reporter CountryUS
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,User Facility
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 03/21/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Model Number11460-010T
Device Catalogue Number11460-010T
Device Lot NumberV3A209
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/24/2023
Initial Report FDA Received Date03/21/2023
Date Device Manufactured01/22/2023
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexFemale
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