FDA Adverse Event Other Summary report: N

PRIMUS

MDR report key: 2110088 · Received May 23, 2011

Report

Report Number
9611500-2011-00015
Event Type
Other
Date Received
May 23, 2011
Date of Event
April 7, 2011
Report Date
May 13, 2011
Manufacturer
DRAGER MEDICAL GMBH
Product Code
BSZ
PMA / PMN Number
K042607
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS ONGOING. THE RESULTS OF THE INVESTIGATION WILL BE PART OF A FOLLOW-UP.

Description of Event or Problem · 1

IT WAS REPORTED: "STOP OF RESPIRATOR DURING USE. NO AUDIBLE ALARM, ONLY A VISUAL ALARM: RED CROSS ON THE LOWER LEFT CORNER OF THE RESPIRATOR + MESSAGE "VENTILATOR FAILURE". IN ADDITION IT WAS REPORTED THAT THE PATIENT HAS DESATURATED (B)(6) AND THAT AN INCREASE OF THE DURATION OF THE INTERVENTION OF MORE THAN 30 MINUTES OCCURRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PRIMUS ANESTHESIA WORKSTATION BSZ DRAGER MEDICAL GMBH NA

Patients

Seq Age Sex Outcome Treatment
1 3 YR Required Intervention