BEUDAMED
    FDA Adverse Event Other Summary report: N

    FNL LIBERATOR 45 TF G3 SPAIN

    MDR report key: 1368837 · Received April 23, 2009

    Report

    Report Number
    3004822415-2009-00001
    Event Type
    Other
    Date Received
    April 23, 2009
    Date of Event
    October 16, 2007
    Report Date
    April 10, 2009
    Manufacturer
    CAIRE, INC.
    Product Code
    BYJ
    PMA / PMN Number
    K800742
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SP
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    ACCIDENT IN USING OF A LOX RESPIRATORY THERAPY DURING THE LIGHTING OF A GAS HEATER BECAUSE OF DEFLAGRATION AND OXYGEN MASK COMBUSTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FNL LIBERATOR 45 TF G3 SPAIN LOX BASE UNIT BYJ CAIRE, INC. LIBERATOR 45 TF

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Other