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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: CHATTEM ICY HOT SMART RELIEF TENS BACK PAIN THERAPY TRANSCUTANEOUS NERVE STIMULATOR

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CHATTEM ICY HOT SMART RELIEF TENS BACK PAIN THERAPY TRANSCUTANEOUS NERVE STIMULATOR Back to Search Results
Lot Number 178105
Device Problems Device Operates Differently Than Expected (2913); Temperature Problem (3022)
Patient Problems Burning Sensation (2146); Burn, Thermal (2530)
Event Type  Injury  
Event Description
Based on additional information received on 08-aug- 2017, this case was upgraded to serious from nonserious (events of piece of skin came off described as closer to the size of a dime, had stinging, application site burning were added, seriousness criteria: important medical event was added) initial information regarding this unsolicited case from united states was received from a non-healthcare professional on 04-aug-2017. This case involves a female patient of unspecified age, whose piece of skin came off described as closer to the size of a dime, had stinging, application site burning (reported as burn-thermal) after started using smart relief tens therapy (icy hot smart relief tens back pain therapy). The patient had back surgery on l4, l5 and s1 (lower region half way over by her hip) in 1992 and again in 2001 prior to use of the device. Past drugs and concomitant medications were not reported. On unknown date, the patient used smart relief tens therapy at an unspecified frequency (lot/batch number: 178105 and expiry date: 31-may-2019) for back pain. Electrode pad lot number: b-16-09-12, expiry date: 31- may-2019, serial number: (b)(4). Reportedly, the patient had a burn thermal on (b)(6) 2017 (latency: unknown), after using the smart relief tens therapy. The reporter stated the event was related to burns. The patient's piece of skin came off and had stinging (onset date and latency: unknown) burning sensation after starting smart relief tens therapy. The patient bought it and she used it when she got home last night between 2:30 am and 3:00 am. The reporter used the device in a rolling desk chair. The reporter touched the device and could feel the sensation when the patient went to remove the electrode pad, she noticed a burning sensation. She also noticed a stinging burning sensation. After taking the device off, a piece of her skin came off, described as closer to the size of a dime (onset date and latency: unknown). She had checked the electrode pad was unable to locate the piece of skin. The reporter provided the device was placed above her butt check halfway across the spine to the hip on the right side, about where the waistline was for jeans. It was verified that the device was not placed over the spine. Action taken: unknown. Corrective treatment: not reported. Outcome: unknown for all the events. Seriousness criteria: important medical event for all the events additional information was received on 08-aug-2017, this case was upgraded to serious from non-serious (events of piece of skin came off described as closer to the size of a dime, had stinging, application site burning were added, seriousness criteria: important medical event was added). Event verbatim updated to burn-thermal. Lot batch details and gender updated. Medical history added. Clinical course updated. Text amended accordingly.
 
Event Description
The case ((b)(6)) was found to be a duplicate to the case ((b)(6)). Hence the case (b)(6) qualifies for deletion. The additional information of the case (b)(6) has been incorporated in the active case. Based on additional information received on 08-aug- 2017, this case was upgraded to serious from nonserious (events of piece of skin came off described as closer to the size of a dime, had stinging, application site burning were added, seriousness criteria: important medical event was added) initial information regarding this unsolicited case from united states was received from a non-healthcare professional on 04-aug-2017. This case involves a female patient of unspecified age, whose piece of skin came off described as closer to the size of a dime (tissue damage), had stinging, application site burning (reported as burn-thermal) after started using smart relief tens therapy (icy hot smart relief tens back pain therapy). The patient had back surgery on l4, l5 and s1 (lower region half way over by her hip) in 1992 and again in 2001 prior to use of the device. Past drugs and concomitant medications were not reported. On unknown date, the patient used smart relief tens therapy at an unspecified frequency (lot/batch number: 178105 and expiry date: 31-may-2019) for back pain. Electrode pad lot number: b-16-09-12, expiry date: 31-may- 2019, serial number: (b)(4). Reportedly, the patient had a burn thermal on (b)(6) 2017 (latency: unknown), after using the smart relief tens therapy. The reporter stated the event was related to burns. The patient's piece of skin came off and had stinging (onset date and latency: unknown) burning sensation after starting smart relief tens therapy. The patient bought it and she used it when she got home last night between 2:30 am and 3:00 am. The reporter used the device in a rolling desk chair. The reporter touched the device and could feel the sensation when the patient went to remove the electrode pad, she noticed a burning sensation. She also noticed a stinging burning sensation. After taking the device off, a piece of her skin came off, described as closer to the size of a dime (onset date and latency: unknown). She had checked the electrode pad was unable to locate the piece of skin. The reporter provided the device was placed above her butt check halfway across the spine to the hip on the right side, about where the waistline was for jeans. It was verified that the device was not placed over the spine. Patient had tissue damage and experienced burn-thermal. Qa review was performed and investigation findings were reported as 'this product meets the monograph standard. All specifications have been met and quality reports do not reveal any issues with this product. Complaints pertaining to consumer adverse events are trended and presented to management monthly. In the absence of the product formulation, lot number, and complaint sample; no further qa investigation is possible. ' action taken: unknown. Corrective treatment: not reported. Outcome: unknown for all the events. Reporter causality description: related seriousness criteria: important medical event for all the events additional information was received on 08-aug-2017, this case was upgraded to serious from non-serious (events of piece of skin came off described as closer to the size of a dime, had stinging, application site burning were added, seriousness criteria: important medical event was added). Event verbatim updated to burn-thermal. Lot batch details and gender updated. Medical history added. Clinical course updated. Text amended accordingly. Additional information was received from a consumer and the quality department on 10-aug-2017: event verbatim updated to piece of skin came off described as closer to the size of a dime (tissue damage). Qa finding added. The case ((b)(6)) was found to be a duplicate to the case ((b)(6)). Hence the case (b)(6) qualifies for deletion. The additional information of the case (b)(6) has been incorporated in the active case. Text amended accordingly. Pharmacovigilance comment: sanofi company comment dated 10-08-2017:this case concerns a female patient who experienced exfoliation at application site whilst being on the device smart relief tens therapy. The causal role of suspect device cannot be ruled out , however this case lacks information regarding the condition of the skin at the contact area prior to applying the device if wet, dry or open wounds and furthermore the pictures of the burn area which are yet not available would provide the comprehensive assessment of the case.
 
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Brand NameICY HOT SMART RELIEF TENS BACK PAIN THERAPY
Type of DeviceTRANSCUTANEOUS NERVE STIMULATOR
Manufacturer (Section D)
CHATTEM
1715 west 38th street
chattanooga TN 37409
Manufacturer Contact
heather schiappacasse
55 corporate drive
55b-220a
bridgewater, NJ 08807
9089817289
MDR Report Key6848815
MDR Text Key85139713
Report Number1022556-2017-00006
Device Sequence Number1
Product Code NUH
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K131159
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type consumer
Reporter Occupation Patient
Type of Report Initial,Followup
Report Date 08/04/2017
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received09/07/2017
Is this an Adverse Event Report? Yes
Device Operator
Device Expiration Date05/31/2019
Device Lot Number178105
Was Device Available for Evaluation? No Answer Provided
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Event Location No Information
Date Manufacturer Received08/08/2017
Was Device Evaluated by Manufacturer? No Answer Provided
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device?
Type of Device Usage

Patient Treatment Data
Date Received: 09/07/2017 Patient Sequence Number: 1
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