BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    KING SYSTEMS CORPORATION

    MDR report key: 157755 · Received March 17, 1998

    Report

    Report Number
    MW1013222
    Event Type
    Malfunction
    Date Received
    March 17, 1998
    Date of Event
    March 12, 1998
    Report Date
    March 17, 1998
    Manufacturer
    KING SYSTEM CORP.
    Product Code
    CAI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    CARBON DIOXIDE SAMPLING PORT PULLED OUT OF CIRCUIT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KING SYSTEMS CORPORATION NON-CONDUCTIVE ANESTHESIA CIRCUIT WITH FILTER AND BREATHING CAI KING SYSTEM CORP. * 0199J7

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other