FDA Adverse Event Injury Summary report: N

ULTRA PC% FLOWMETER

MDR report key: 21332938 · Received February 7, 2025

Report

Report Number
2020813-2025-00001
Event Type
Injury
Date Received
February 7, 2025
Date of Event
January 8, 2025
Report Date
February 7, 2025
Manufacturer
ACCUTRON INC.
Product Code
BSZ
UDI-DI
00813830021158
PMA / PMN Number
K970163
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
KS, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

A COMPLETE AND THOROUGH TEST AND EVALUATION WAS CONDUCTED ON THE DEVICE IN AS RECEIVED CONDITION. TESTING FOUND O2 & N2O MIXED GAS FLOWS WERE WITHIN IN FACTORY TOLERANCES. DEVICE TESTED AND MEETS FACTORY REQUIREMENTS.

Description of Event or Problem · 0

USER FACILITY REPORTED THAT 2 PATIENTS GOT SICK AT 40% FLOW AND DR. WAS CONCERNED ABOUT METER FLOWING ACCURATELY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1248314 ULTRA PC% FLOWMETER FLOWMETER BSZ ACCUTRON INC. 31975 00813830021158

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other