BEUDAMED
    FDA Adverse Event Death Summary report: N

    AIRSEP

    MDR report key: 1064614 · Received June 17, 2008

    Report

    Report Number
    1064614
    Event Type
    Death
    Date Received
    June 17, 2008
    Date of Event
    June 2, 2008
    Report Date
    June 12, 2008
    Manufacturer
    AIR SEP CORP
    Product Code
    CAW
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    NJ, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    WHILE ON AN O2 GENERATING MACHINE, THE VICTIM DIED FROM INHALING THE PRODUCTS OF COMBUSTION. IT IS BELIEVED THAT THE O2 MACHINE CAUGHT FIRE, AND PUMPED SMOKE INTO THE NASAL CANNULA THAT THE VICTIM WAS USING. VICTIM WAS ALSO A SMOKER, AND WAS PROBABLY SMOKING AT TIME OF FIRE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AIRSEP AIR JEN NEW LIFE ELITE CAW AIR SEP CORP NEW LIFE ELITE

    Patients

    Seq Age Sex Outcome Treatment
    1 65 YR Death