FDA Adverse Event
Death
Summary report: N
OXYGEN CYLINDER
MDR report key: 210541
·
Received February 8, 1999
Report
- Report Number
- 1223412-1999-00002
- Event Type
- Death
- Date Received
- February 8, 1999
- Date of Event
- January 11, 1999
- Report Date
- February 8, 1999
- Manufacturer
- CONTEMPORARY PRODUCTS, INC.
- Product Code
- CAW
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NV, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
IT WAS REPORTED TO CONTEMPORARY PRODUCTS INC.(CPI) THAT A PT WAS IN THE EXAM ROOM. THE PT WAS IN THE EXAM ROOM WAITING FOR THE DR WHEN SHE HEARD A "POP AND A SWOOSH NOISE, AND RUN-OUT OF THE OFFICE ON FIRE". THE PT WAS FLOWN BY HELICOPTER TO A TRAUMA CENTER FOR TREATMENT. IT WAS REPORTED TO CPI ON 02/05/1999 THAT THE PT PERISHED ON 01/23/1999. THIS REPORT IS FOR THE SAME INCIDENT REPORTED ON MDR 1223412-1999-00001.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | OXYGEN CYLINDER | COMPRESSED GAS CYLINDER | CAW | CONTEMPORARY PRODUCTS, INC. | OL-150 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Death |