FDA Adverse Event Malfunction Summary report: N

OUT PATIENT REGU-GAGE

MDR report key: 1003928 · Received January 31, 2008

Report

Report Number
1003928
Event Type
Malfunction
Date Received
January 31, 2008
Date of Event
December 20, 2007
Report Date
January 31, 2008
Manufacturer
ALLIED HEALTH CARE PRODUCTS, INC.
Product Code
GCX
Product Problem
Yes
Report Source
User Facility report
Reporter Location
TN, US

Narratives

Description of Event or Problem · 1

THE SUCTION EQUIPMENT WAS CHECKED PRIOR TO THE BEGINNING OF THE PROCEDURE, AND WAS IN WORKING ORDER. THE SUCTION EQUIPMENT WORKED THE FIRST TIME IT WAS NEEDED. HOWEVER, THE PHYSICIAN STATED THAT IT DID NOT SEEM TO SUCTION CORRECTLY THE FIRST TIME, THOUGH THE NURSE INVOLVED IN THIS CASE DISPUTES THIS STATEMENT. THE SECOND TIME THE SUCTION DEVICE WAS USED, THE EQUIPMENT FAILED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 OUT PATIENT REGU-GAGE GENERATOR, SUCTION GCX ALLIED HEALTH CARE PRODUCTS, INC. * *

Patients

Seq Age Sex Outcome Treatment
1 50 YR SUCTION TUBING. BIOMED DID DETERMINE THAT THE FAIL| NO OTHER THERAPIES| NONE THAT WOULD HAVE CAUSED OR CONTRIBUTED TO THE| NO OTHER THERAPIES| CANISTER OR TUBING.| CANISTER OR TUBING.| ON EQUIPMENT HAS THE SUCTION DEVICE, CANISTER AND| SUCTION TUBING. BIOMED DID DETERMINE THAT THE FAIL| URE WAS DUE TO THE SUCTION EQUIPMENT, AND NOT THE| URE WAS DUE TO THE SUCTION EQUIPMENT, AND NOT THE| EVENT, BUT THE TEE PROBE WAS BEING USED. THE SUCTI| NONE THAT WOULD HAVE CAUSED OR CONTRIBUTED TO THE| ON EQUIPMENT HAS THE SUCTION DEVICE, CANISTER AND| EVENT, BUT THE TEE PROBE WAS BEING USED. THE SUCTI