FDA Adverse Event Malfunction Summary report: N

DELTA

MDR report key: 1879325 · Received October 19, 2010

Report

Report Number
1220063-2010-00060
Event Type
Malfunction
Date Received
October 19, 2010
Report Date
September 21, 2010
Manufacturer
DRAGER MEDICAL SYSTEMS, INC. (IT/M)
Product Code
MHX
PMA / PMN Number
UNK
Removal / Correction Number
Z-2283/4-2010
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

AN INVESTIGATION WAS INITIATED WITH THE SUPPLIER OF THE SWITCH PANEL. IT WAS DETERMINED THAT THIS CONDITION IS DUE TO A CONTAMINATION PRESENT IN THE FIXED KEY PANEL MATERIAL. A RISK ANALYSIS WAS PERFORMED. DRAEGER MEDICAL INITIATED A RECALL ON 06/04/2010 TO ADDRESS THIS PROBLEM. NO PT DEATHS OR INJURIES HAVE BEEN REPORTED AS A RESULT OF THIS CONDITION.

Description of Event or Problem · 1

REFERENCE: MDR 1220063-2010-00054. IT WAS REPORTED THAT THE BEZEL IS CAUSING THE MONITOR TO RANDOMLY PRINT AND SHUT OFF. THERE WAS NO PT INJURY REPORTED. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DELTA PT MONITOR MHX DRAGER MEDICAL SYSTEMS, INC. (IT/M) UNK NA

Patients

Seq Age Sex Outcome Treatment
1 UNK NO