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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: JABIL CIRCUIT (SHANGHAI) LTD LATITUDE COMMUNICATOR; EXTERNAL COMMUNICATOR

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JABIL CIRCUIT (SHANGHAI) LTD LATITUDE COMMUNICATOR; EXTERNAL COMMUNICATOR Back to Search Results
Model Number 6280
Medical Device Problem Code Power Problem (3010)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/03/2023
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
As no further information concerning this report is expected, our investigation is complete.This investigation will be updated should further information be provided.
 
Event or Problem Description
It was reported that the communicator continually reboots, and the communicator power cord had a short.A boston scientific company representative performed troubleshooting with the communicator connection, and the communicator was able to connect and update firmware.The patient had to hold the communicator in her hands and had to carefully place the communicator back down to avoid a reboot.The company representative opted to replace the power cord and cellular adapter.No adverse patient effects were reported.The communicator remains in service.
 
Event or Problem Description
It was reported that the communicator continually reboots, and the communicator power cord had a short.A boston scientific company representative performed troubleshooting with the communicator connection, and the communicator was able to connect and update firmware.The patient had to hold the communicator in her hands and had to carefully place the communicator back down to avoid a reboot.The company representative opted to replace the power cord and cellular adapter.No adverse patient effects were reported.The communicator remains in service.
 
Additional Manufacturer Narrative
Adverse event and product problem on b1 field was changed to product problem.As no further information concerning this report is expected, our investigation is complete.This investigation will be updated should further information be provided.
 
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Brand Name
LATITUDE COMMUNICATOR
Common Device Name
EXTERNAL COMMUNICATOR
Manufacturer (Section D)
JABIL CIRCUIT (SHANGHAI) LTD
600 tian lin rd
shanghai
CH 
Manufacturer Contact
timothy degroot
4100 hamline avenue north
saint paul, MN 55112
6515826168
MDR Report Key17286343
Report Number2124215-2023-35837
Device Sequence Number3022470
Product Code LWS
UDI-Device Identifier00802526570209
UDI-Public00802526570209
Combination Product (Y/N)N
Initial Reporter StateIL
Initial Reporter CountryUS
PMA/510(K) Number
P910077/S140
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 07/13/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Operator of Device Lay User/Patient
Device Model Number6280
Device Catalogue Number6280
Device Lot Number5037992
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 07/03/2023
Supplement Date Received by Manufacturer07/03/2023
Initial Report FDA Received Date07/10/2023
Supplement Report FDA Received Date07/13/2023
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient Age48 YR
Patient SexFemale
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