BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SERVO I

    MDR report key: 1000367 · Received February 15, 2008

    Report

    Report Number
    MW5005584
    Event Type
    Injury
    Date Received
    February 15, 2008
    Date of Event
    February 8, 2008
    Report Date
    February 15, 2008
    Manufacturer
    MAQUET
    Product Code
    CBK
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    GA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PRE USER CHECK WAS DONE ON VENT BEFORE INSTALL, EVERYTHING PASSED. PT WAS TRANSPORTED TO CT ON VENT WITH NO PROBLEM. UPON ARRIVING IN, CT ATTEMPTED TO PLUG VENT INTO POWER SOURCE. VENT DISABLED ITSELF/STOPPED VENTILATION (AIR AND O2 WERE ALREADY HOOKED UP, POWER SOURCE WAS CHECKED, WAS WORKING). VENT MESSAGE READ REPLACE BATTERY/WOULD NOT QUIT BEEPING OR VENTILATE. PT HAD TO BE MANUALLY VENTILATED VIA AMBO BAG.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SERVO I VENTILATOR CBK MAQUET 6449701E470E

    Patients

    Seq Age Sex Outcome Treatment
    1 77 YR Required Intervention