BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CARE E VAC III

    MDR report key: 1626188 · Received January 27, 2010

    Report

    Report Number
    1419185-2010-13101
    Event Type
    Malfunction
    Date Received
    January 27, 2010
    Date of Event
    August 26, 2009
    Report Date
    January 27, 2010
    Manufacturer
    OHIO MEDICAL CORPORATION
    Product Code
    BTA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    THE COMPLAINANT STATED THAT THE UNIT WAS SMOKING AND NOW ONLY RUNS ON A/C. THE POWER INDICATOR LIGHT WAS ALSO NOT ON WHEN THE UNIT WAS IN USE. THE UNIT WAS RETURNED TO OHIO MEDICAL CORP FOR FURTHER EVAL. THE DEVICE WAS RETURNED TO OHIO MEDICAL CORP AND A REPLACEMENT UNIT WAS SENT TO THE CUSTOMER. THE DAMAGED UNIT WAS KEPT FOR FURTHER EVAL BY QA AND ENGINEERING. THIS EVENT DID NOT CONTRIBUTE TO A DEATH, ILLNESS OR INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CARE E VAC III PORTABLE SUCTION DEVICE BTA OHIO MEDICAL CORPORATION 3 CEB081010

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK Other