FDA Adverse Event Malfunction Summary report: N

FLOWMETER, DIGITAL FLUSHMOUNT

MDR report key: 20966581 · Received December 18, 2024

Report

Report Number
2020813-2024-00003
Event Type
Malfunction
Date Received
December 18, 2024
Date of Event
October 16, 2024
Report Date
December 18, 2024
Manufacturer
ACCUTRON INC.
Product Code
BSZ
PMA / PMN Number
K052335
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CT, US
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

MANUFACTURER WAS ABLE TO CONFIRM REPORTED PROBLEM WITH SUSPECTED DEVICE. PROBLEM IS RELATED TO A FAILED MASS FLOW SENSOR ALONG WITH THE MAIN PC BOARD. NOT CLEAR WHY THE SENSOR AND PC BOARD FAILED.

Description of Event or Problem · 0

USER FACILITY REPORTED THAT TWO PATIENTS WENT INTO DEEP SEDATION. BOTH PROCEDURES WERE STOPPED. THERE WAS NO PATIENT HARM, AND NO MEDICAL INTERVENTION WAS NEEDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1987833 FLOWMETER, DIGITAL FLUSHMOUNT FLOWMETER BSZ ACCUTRON INC. 27076

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other