FDA Adverse Event Malfunction Summary report: N

RAD-97 PULSE CO-OXIMETER

MDR report key: 18384863 · Received December 22, 2023

Report

Report Number
3019388613-2023-00281
Event Type
Malfunction
Date Received
December 22, 2023
Date of Event
November 1, 2023
Report Date
December 1, 2023
Manufacturer
MASIMO - 15750 ALTON PKWY
Product Code
MWI
UDI-DI
00843997012317
PMA / PMN Number
K212161
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
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. H3 OTHER TEXT : DEVICE NOT RETURNED.

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 (9738). H3 OTHER TEXT: PRODUCT NOT RETURNED.

Description of Event or Problem · 0

THE CUSTOMER REPORTED THAT THE RAD-97 DEVICE "READS A SPO2 MEASUREMENT FOR ABOUT A MINUTE THEN IT WILL STOP READING." THERE WAS NO PATIENT IMPACT OR CONSEQUENCE REPORTED.

Description of Event or Problem · 0

THE CUSTOMER REPORTED THAT THE RAD-97 DEVICE "READS A SPO2 MEASUREMENT FOR ABOUT A MINUTE THEN IT WILL STOP READING." THERE WAS NO PATIENT IMPACT OR CONSEQUENCE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2290406 RAD-97 PULSE CO-OXIMETER MONITOR, PHYSIOLOGICAL, PATIENT (WITHOUT ARRHYTHMIA DETECTION OR ALARMS) MWI MASIMO - 15750 ALTON PKWY 9738 00843997012317

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown