FDA Adverse Event Malfunction Summary report: N

RAD-57 PULSE CO-OXIMETER

MDR report key: 17401953 · Received July 26, 2023

Report

Report Number
3019388613-2023-00186
Event Type
Malfunction
Date Received
July 26, 2023
Date of Event
June 26, 2023
Report Date
July 3, 2023
Manufacturer
MASIMO - 15750 ALTON PKWY
Product Code
DQA
UDI-DI
00843997006163
PMA / PMN Number
K053477
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
BIOMEDICAL ENGINEER
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL MANUFACURING NARRATIVE: ATTEMPTS HAVE BEEN MADE TO OBTAIN THE PRODUCT. THE PRODUCT HAS NOT BEEN RETURNED TO MASIMO TO ALLOW AN ANALYSIS TO BE PERFORMED. IF THE PRODUCT IS RETURNED FOR EVALUATION OR NEW INFORMATION IS OBTAINED, A FOLLOW UP REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

ADDITIONAL MANUFACTURING NARRATIVE: THE RETURNED DEVICE WAS EVALUATED. DURING EVALUATION THE DEVICE PASSED ALL VISUAL AND FUNCTIONAL TESTING. DURING SIMULATION TESTING, THE DEVICE PASSED MANUAL AND PRESET CONDITIONS AND PROVIDED ACCURATE MEASUREMENTS. THE UNIT WAS FOUND TO VISUALLY AND AUDIBLY ALARM DURING ALARM CONDITIONS. THE UNIT WAS DETERMINED TO BE FUNCTIONING AS DESIGNED., OTHER, OTHER TEXT: THE CUSTOMER MX-51 BOARD DID NOT HAVE THE SPMET PARAMETER ENABLED AND SPMET MEASUREMENTS COULD NOT BE OBTAINED. G.5. 510K WAS LISTED AS:K080238; IS K053477.

Description of Event or Problem · 0

THE CUSTOMER REPORTED THE SPMET VALUES WERE READING HIGHER THAN THEY SHOULD. NO PATIENT IMPACT OR CONSEQUENCES WERE REPORTED.

Description of Event or Problem · 0

THE CUSTOMER REPORTED THE SPMET VALUES WERE READING HIGHER THAN THEY SHOULD. NO PATIENT IMPACT OR CONSEQUENCES WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1106715 RAD-57 PULSE CO-OXIMETER OXIMETER DQA MASIMO - 15750 ALTON PKWY 25195 00843997006163

Patients

Seq Age Sex Outcome Treatment
1 Unknown