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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 6290
Medical Device Problem Code Communication or Transmission Problem (2896)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/07/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the communicator universal serial bus (usb) ethernet adapter was getting warm and the plastic on it was starting to melt.A boston scientific technical services (ts) assisted the patient in troubleshooting.The patient was advised to immediately remove the universal serial bus (usb) adapter and wait for the replacement.The communicator issue persisted.The company representative advised replacing the communicator.The communicator was no longer in service.No adverse patient effects were reported.
 
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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 Key25322677
Report Number2124215-2026-28656
Device Sequence Number17462961
Product Code OSR
UDI-Device Identifier00802526570322
UDI-Public(01)00802526570322
Combination Product (Y/N)N
Initial Reporter StateME
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
Report Date (Section B) 05/28/2026
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 Lay User/Patient
Device Model Number6290
Device Catalogue Number6290
Device Lot Number5019836
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/07/2026
Initial Report FDA Received Date05/28/2026
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 Age39 YR
Patient SexMale
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