Medical device recalls: May 2019
The FDA posted 205 medical device recall records in May 2019, from 9 recall events by 9 companies. 11 are Class I, the most serious category.
Each product in a recall gets its own record, so one recall event can cover several records. What recall classes mean.
Companies with the most recall events
- Maquet Cardiovascular, LLC · 1 event, 183 records
- Boston Scientific Corporation · 1 event, 9 records
- Beckman Coulter Inc. · 1 event, 3 records, 3 Class I
- Integra LifeSciences Corp. · 1 event, 3 records, 3 Class I
- Terumo Medical Corporation · 1 event, 3 records, 3 Class I
- Alpha Omega Engineering · 1 event, 1 record, 1 Class I
- Edwards Lifesciences, LLC · 1 event, 1 record, 1 Class I
- Elekta Limited · 1 event, 1 record
FDA root cause
- Device Design · 190
- Component design/selection · 9
- Software Design Change · 3
- Use error · 1
- Under Investigation by firm · 1
- Labeling design · 1
Class I recalls (11)
The most serious: a reasonable probability that using the device will cause serious health problems or death.
- Z-1374-2019 · Terumo Medical Corporation · posted May 28, 2019 · Terminated
There is a potential for dislodgement of the tip from the outer diameter of the sheath resulting in a loss of the smooth transition from the surface of the tip to the outer surface of the expandable sheath.
- Z-1375-2019 · Terumo Medical Corporation · posted May 28, 2019 · Terminated
There is a potential for dislodgement of the tip from the outer diameter of the sheath resulting in a loss of the smooth transition from the surface of the tip to the outer surface of the expandable sheath.
- Z-1376-2019 · Terumo Medical Corporation · posted May 28, 2019 · Terminated
There is a potential for dislodgement of the tip from the outer diameter of the sheath resulting in a loss of the smooth transition from the surface of the tip to the outer surface of the expandable sheath.
- Z-1382-2019 · Beckman Coulter Inc. · posted May 23, 2019 · Terminated
Complaints received of sporadic erroneously elevated platelet results without flags or system messages. Thrombocytopenia may go unrecognized.
- Z-1383-2019 · Beckman Coulter Inc. · posted May 23, 2019 · Terminated
Complaints received of sporadic erroneously elevated platelet results without flags or system messages. Thrombocytopenia may go unrecognized.
- Z-1384-2019 · Beckman Coulter Inc. · posted May 23, 2019 · Terminated
Complaints received of sporadic erroneously elevated platelet results without flags or system messages. Thrombocytopenia may go unrecognized.
- Z-1193-2019 · Edwards Lifesciences, LLC · posted May 21, 2019 · Terminated
Potential for an electrical short circuit leading to possible fire hazard due to liquid ingress into AC power outlets.
- Z-1310-2019 · Integra LifeSciences Corp. · posted May 20, 2019 · Terminated
The firm has identified a complaint trend regarding breakage of the LimiTorr Transducer Mount stopcock and MoniTorr Panel Mount stopcock.
- Z-1311-2019 · Integra LifeSciences Corp. · posted May 20, 2019 · Terminated
The firm has identified a complaint trend regarding breakage of the LimiTorr Transducer Mount stopcock and MoniTorr Panel Mount stopcock.
- Z-1312-2019 · Integra LifeSciences Corp. · posted May 20, 2019 · Terminated
The firm has identified a complaint trend regarding breakage of the LimiTorr Transducer Mount stopcock and MoniTorr Panel Mount stopcock.
- Z-1216-2019 · Alpha Omega Engineering · posted May 6, 2019 · Terminated
If cables are improperly connected, current may reach high charge density, causing tissue harm.
Class II recalls (194)
The device may cause temporary or medically reversible health problems, or the chance of serious harm is remote.
- Z-1498-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1499-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1500-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1501-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1502-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Maquet Getinge-BEQ-T-22800 ↗Class IIZ-1503-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1504-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1505-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1506-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1507-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1508-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Maquet Getinge-BEQ-TOP 22701 ↗Class IIZ-1509-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Maquet Getinge-BEQ-TOP 4901 ↗Class IIZ-1510-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1511-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1512-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1513-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Maquet Getinge-BEQ-TOP 15705 ↗Class IIZ-1514-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1515-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1516-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1517-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1518-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1519-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1520-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1521-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Maquet Getinge-BO-TOP 30300 ↗Class IIZ-1522-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1523-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1524-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1525-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1526-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1527-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1528-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1529-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1530-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1531-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1532-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1533-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1534-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1535-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1536-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1537-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1538-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1539-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1540-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1541-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1542-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1543-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1544-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1545-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1546-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1547-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1548-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1549-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1550-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1551-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1552-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1553-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1554-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1555-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1556-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1557-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1558-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1559-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1560-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1561-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1562-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1563-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1564-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1565-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1566-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1567-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1568-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1569-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1570-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1571-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1572-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1573-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1574-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1575-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1576-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1577-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1578-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1579-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1580-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1581-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1582-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1583-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1584-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1585-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1586-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1587-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1588-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1589-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1590-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1591-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1592-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1593-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1594-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1595-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1596-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1597-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1598-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1599-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1600-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1601-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1602-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1603-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1604-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1605-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1606-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1607-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1608-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1609-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1610-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1611-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1612-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1613-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1614-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1615-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1616-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1617-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1618-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1619-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1620-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1621-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1622-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1623-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1624-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1625-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1626-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1627-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1628-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1629-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1630-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1631-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1632-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1633-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1634-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1635-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1636-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1637-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1638-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1639-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1640-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1641-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1642-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1643-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1644-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1645-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Maquet Getinge: ↗Class IIZ-1646-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1647-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1648-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1649-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1650-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1651-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1652-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Maquet Getinge- ↗Class IIZ-1653-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1654-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1655-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1656-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1657-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Maquet Getinge- ↗Class IIZ-1658-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1659-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1660-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1661-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1662-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Maquet Getinge- ↗Class IIZ-1663-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1664-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1665-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1666-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Maquet Getinge- ↗Class IIZ-1667-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1668-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Maquet Getinge- ↗Class IIZ-1669-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1670-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1671-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1672-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1673-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1674-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1675-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1676-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1677-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1678-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1679-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- Z-1680-2019 · Maquet Cardiovascular, LLC · posted May 31, 2019 · Terminated
- AURIGA XL 4007 BRAZIL SYSTEM ↗Class IIZ-1391-2019 · Boston Scientific Corporation · posted May 22, 2019 · Terminated
- AURIGA XL 4007 GENERAL SYSTEM ↗Class IIZ-1392-2019 · Boston Scientific Corporation · posted May 22, 2019 · Terminated
- Z-1393-2019 · Boston Scientific Corporation · posted May 22, 2019 · Terminated
- AURIGA XL 4007 GENERAL - ZERO ↗Class IIZ-1394-2019 · Boston Scientific Corporation · posted May 22, 2019 · Terminated
- AURIGA 30 BRAZIL SYSTEM ↗Class IIZ-1395-2019 · Boston Scientific Corporation · posted May 22, 2019 · Terminated
- Z-1396-2019 · Boston Scientific Corporation · posted May 22, 2019 · Terminated
- AURIGA 30 GENERAL SYSTEM ↗Class IIZ-1397-2019 · Boston Scientific Corporation · posted May 22, 2019 · Terminated
- Z-1398-2019 · Boston Scientific Corporation · posted May 22, 2019 · Terminated
- Z-1399-2019 · Boston Scientific Corporation · posted May 22, 2019 · Terminated
- Z-1350-2019 · Stryker Medical Division of Stryker Corporation · posted May 15, 2019 · Terminated
- Elekta Unity systemsClass IIZ-1297-2019 · Elekta Limited · posted May 8, 2019 · Terminated
Source: FDA Medical Device Recalls and FDA enforcement reports (recall class), via openFDA. Records are grouped by the date the FDA posted them. Methodology · Not medical advice.