BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    E CYLINDER WITH INTEGRATED FLOW METER

    MDR report key: 1912867 · Received September 30, 2010

    Report

    Report Number
    MW5018326
    Event Type
    Malfunction
    Date Received
    September 30, 2010
    Date of Event
    September 19, 2010
    Report Date
    September 23, 2010
    Manufacturer
    LIFE GAS COMPANY
    Product Code
    BYJ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MI, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    WHILE PUSHING A WHEELCHAIR DOWN THE HALL, THE ATTACHED VALVE ON THE OXYGEN TANK BLEW OFF. THERE WAS NO BUMPING OF THE TANK. THE RESPIRATORY THERAPIST STATED THAT THE VALVE WAS LEAKING VERY LOUDLY, WAS THE FILLING VALVE. THE LEAK WAS UNABLE TO BE STOPPED AND HAD TO WAIT UNTIL THE OXYGEN TANK COMPLETELY EMPTIED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 E CYLINDER WITH INTEGRATED FLOW METER NONE BYJ LIFE GAS COMPANY 252E005

    Patients

    Seq Age Sex Outcome Treatment
    1