FDA Adverse Event Malfunction Summary report: N

RAD-97 PULSE CO-OXIMETER WITH NOMOLINE CAPNOGRAPHY

MDR report key: 18314293 · Received December 12, 2023

Report

Report Number
3019388613-2023-00278
Event Type
Malfunction
Date Received
December 12, 2023
Date of Event
November 13, 2023
Report Date
November 17, 2023
Manufacturer
MASIMO - 15750 ALTON PKWY
Product Code
MWI
UDI-DI
00843997012782
PMA / PMN Number
K212161
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SA
Reporter Occupation
BIOMEDICAL ENGINEER
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL MANUFACURING NARRATIVE: OTHER, OTHER TEXT: THE DEVICE HAS NOT BEEN RETURNED TO THE INVESTIGATION FACILITY TO ALLOW FOR AN ANALYSIS TO BE PERFORMED. IF THE PRODUCT IS RECEIVED FOR EVALUATION OR NEW INFORMATION IS OBTAINED, A FOLLOW UP REPORT WILL BE SUBMITTED. H3 OTHER TEXT : PRODUCT NOT RETURNED

Additional Manufacturer Narrative · 0

ADDITIONAL MANUFACTURING NARRATIVE: OTHER, OTHER TEXT: THE RETURNED DEVICE HAD A DEPLETED BATTERY AND WOULD TURN OFF AFTER A FEW MINUTES ON BATTERY POWER, HOWEVER, A LOW BATTERY ALARM WAS TRIGGERED WHEN THE DEVICE SHUT DOWN. A "REPLACE SENSOR" ERROR MESSAGE WAS DISPLAYED AND MEASUREMENTS COULD NOT BE OBTAINED AS A RESULT OF RECESSED PINS AT THE PATIENT CABLE CONNECTOR.

Additional Manufacturer Narrative · 0

OTHER, OTHER TEXT: UDI RELATED DATA QUALITY UPDATES ONLY. THIS CORRECTION UPDATES THE UDI INFORMATION, 510K NUMBER, AND MODEL NUMBER TO ENSURE ALIGNMENT WITH GUDID. THE 510K NUMBER IN GUDID WAS UPDATED TO K212161 TO CORRESPOND WITH MASIMO'S 4-DIGIT MODEL NUMBER (9799).

Description of Event or Problem · 0

THE CUSTOMER REPORTED THE RAD-97 POWERED OFF BY ITSELF EVEN WHEN THE DEVICE BATTERY WAS FULLY CHARGED AND HAS AN INTERMITTENT PROBLEM WITH READING SPO2. THERE WAS NO PATIENT IMPACT OR CONSEQUENCE REPORTED.

Description of Event or Problem · 0

THE CUSTOMER REPORTED THE RAD-97 POWERED OFF BY ITSELF EVEN WHEN THE DEVICE BATTERY WAS FULLY CHARGED AND HAS AN INTERMITTENT PROBLEM WITH READING SPO2. THERE WAS NO PATIENT IMPACT OR CONSEQUENCE REPORTED.

Description of Event or Problem · 0

THE CUSTOMER REPORTED THE RAD-97 POWERED OFF BY ITSELF EVEN WHEN THE DEVICE BATTERY WAS FULLY CHARGED AND HAS AN INTERMITTENT PROBLEM WITH READING SPO2. THERE WAS NO PATIENT IMPACT OR CONSEQUENCE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1303765 RAD-97 PULSE CO-OXIMETER WITH NOMOLINE CAPNOGRAPHY MONITOR, PHYSIOLOGICAL, PATIENT (WITHOUT ARRHYTHMIA DETECTION OR ALARMS) MWI MASIMO - 15750 ALTON PKWY 9799 00843997012782

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown