BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CMS GAS STATION

    MDR report key: 161846 · Received April 9, 1998

    Report

    Report Number
    MW1013477
    Event Type
    Malfunction
    Date Received
    April 9, 1998
    Date of Event
    March 15, 1998
    Report Date
    March 23, 1998
    Manufacturer
    SCOTT MEDICAL PRODUCTS DIV. OF SCOTT SPECIALTY GASES
    Product Code
    BXK
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AR, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    BLOOD GAS ANALYZER MALFUNCTION. MACHINE WOULD NOT CALIBRATE. THE SVC REP FOR THE CO DETERMINED THAT THE 12% 02 CALIBRATION GAS WAS BAD. PT WAS TRANSFERRED TO ANOTHER HEALTHCARE FACILITY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CMS GAS STATION CALIBRATION GAS CYLINDER BXK SCOTT MEDICAL PRODUCTS DIV. OF SCOTT SPECIALTY GASES * 093476

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Other