FDA Adverse Event Malfunction Summary report: N

CNS-6801A

MDR report key: 12339569 · Received August 18, 2021

Report

Report Number
2080783-2021-01498
Event Type
Malfunction
Date Received
August 18, 2021
Date of Event
July 21, 2021
Report Date
August 18, 2021
Manufacturer
NIHON KOHDEN CORPORATION
Product Code
MHX
UDI-DI
04931921131640
Product Problem
Yes
Report Source
Distributor report
Reporter Location
HI, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 0

THE CUSTOMER REPORTED THAT THE CENTRAL NURSE'S STATION (CNS) STOPPED RECORDING VITALS FOR PATIENTS THAT WERE ON DEVICES CONNECTED VIA WIFI. THE CUSTOMER STATED THE THE CNS HAS A MIX OF DEVICES, BUT MOSLY GZ-130PA'S WITH ABOUT 5 BSM-1700'S. ACCORDING TO THE CUSTOMER, BED NAME PMTELE-56 GAVE COMM LOSS MESSAGE WHEN THE VITALS SIGNS DISAPPEARED. PATIENT ON DEVICES CONNECTED VIA NETWORK CABLE HAD NO ISSUES. THE CUSTOMER HAS UPLOADED THE LOGS. THERE WAS NO PATIENT INJURY REPORTED. NIHON KOHDEN CONTINUES TO INVESTIGATE THE REPORTED EVENT. NIHON KOHDEN WILL SUBMIT A SUPPLEMENTAL REPORT IN ACCORDANCE WITH 21 CFR SECTION 803.56 WHEN ADDITIONAL INFORMATION BECOMES AVAILABLE. CONCOMITANT MEDICAL DEVICE: THE FOLLOWING DEVICE WAS USED IN CONJUNCTION WITH THE CNS: GZ TRANSMITTERS: MODEL #: NI SERIAL #: NI DEVICE MANUFACTURER DATA: NI UNIQUE IDENTIFIER (UDI) #: NI RETURNED TO NIHON KOHDEN: NI . BEDSIDE MONITORS (BSM'S): MODEL #: NI SERIAL #: NI DEVICE MANUFACTURER DATA: NI UNIQUE IDENTIFIER (UDI) #: NI RETURNED TO NIHON KOHDEN: NI

Description of Event or Problem · 0

THE CUSTOMER REPORTED THAT THE CENTRAL NURSE'S STATION (CNS) STOPPED RECORDING VITALS FOR PATIENTS THAT WERE ON DEVICES CONNECTED VIA WIFI. THERE WAS NO PATIENT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1237665 CNS-6801A CENTRAL MONITOR SYSTEM MHX NIHON KOHDEN CORPORATION CNS-6801A NA 04931921131640

Patients

Seq Age Sex Outcome Treatment
1 BEDSIDE MONITORS (BSM'S)| GZ TRANSMITTERS