BEUDAMED
    FDA Adverse Event Death Summary report: N

    VACU-AIDE

    MDR report key: 14427 · Received January 10, 1994

    Report

    Report Number
    2515872-1993-00002
    Event Type
    Death
    Date Received
    January 10, 1994
    Date of Event
    November 11, 1991
    Report Date
    November 3, 1993
    Manufacturer
    DEVILBISS HEALTH CARE, INC.
    Product Code
    MCJ
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE USER OF THE VACU-AIDE DIED OF CARDIOPULMONARY ARREST. HE SUFFERED FROM BIRTH WITH SPINA BIFIDA AND ARNOLD CHIARI SYNDROME. NOTICE WAS RECEIVED OF THE DEATH ON 10/29/93 AND AN INVESTIGATION IS ONGOING OF THE INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VACU-AIDE MCJ DEVILBISS HEALTH CARE, INC. 7304D UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 16 YR Death