FDA Adverse Event Malfunction Summary report: N

OXYLOG 3000

MDR report key: 2140295 · Received June 9, 2011

Report

Report Number
9611500-2011-00019
Event Type
Malfunction
Date Received
June 9, 2011
Date of Event
May 10, 2011
Report Date
June 9, 2011
Manufacturer
DRAEGER MEDICAL GMBH
Product Code
CBK
PMA / PMN Number
K062267
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE CONCERNED DEVICE WAS REQUESTED FOR INVESTIGATION. INVESTIGATION RESULTS WILL BE REPORTED IN A FOLLOW UP REPORT.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING TRANSPORT OF A PATIENT INSIDE OF AN ELEVATOR, THE VENTILATOR STOPPED VENTILATING AND NO ALARM WAS HEARD. THE DISPLAY SHOWED A HINT TO CALL SERVICE. NO INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 OXYLOG 3000 TRANSPORT VENTILATOR CBK DRAEGER MEDICAL GMBH NA NA

Patients

Seq Age Sex Outcome Treatment
1 UNK Other